Liver safety parameters of ulipristal acetate for the treatment of uterine fibroids: a comprehensive review of the clinical development program

Expert Opin Drug Saf. 2018 Dec;17(12):1225-1232. doi: 10.1080/14740338.2018.1550070. Epub 2018 Nov 29.

Abstract

Introduction: Uterine fibroids are benign tumors within the uterine wall affecting women. Ulipristal acetate 5 mg was first authorized in the European Union on 23 February 2012, with a post-marketing exposure estimated to be more than 765,000 patients so far. During the post-marketing experience, sporadic cases of liver injury and hepatic failure were reported. A detailed review of the clinical trials carried out in the development of ulipristal acetate 5 mg was undertaken to further assess the liver safety data reported during the clinical trials.

Areas covered: A detailed review of clinical data from Phase I to Phase III of patients exposed to ulipristal acetate at any investigated dose levels and for any treatment duration was conducted and the liver function test values are presented. In addition, a literature review on drug-induced liver injury is provided.

Expert opinion: The experts present an evaluation of the liver safety findings observed during the clinical development and their views on the role of these findings in predicting the occurrence of drug-induced liver injury, the benefits of the treatment, the safety and the implications to the current clinical practice.

Keywords: DILI; Drug-induced liver injury; bilirubin; safety; transaminases; ulipristal acetate.

Publication types

  • Review

MeSH terms

  • Chemical and Drug Induced Liver Injury / epidemiology
  • Chemical and Drug Induced Liver Injury / etiology*
  • Contraceptive Agents, Female / administration & dosage
  • Contraceptive Agents, Female / adverse effects
  • Female
  • Humans
  • Leiomyoma / drug therapy*
  • Leiomyoma / pathology
  • Liver Function Tests
  • Norpregnadienes / administration & dosage
  • Norpregnadienes / adverse effects*
  • Uterine Neoplasms / drug therapy*
  • Uterine Neoplasms / pathology

Substances

  • Contraceptive Agents, Female
  • Norpregnadienes
  • ulipristal acetate