For patients with adenomyosis, mifepristone is efficacious and has acceptable tolerability, according to a study published online June 12 in JAMA Network Open.

Xuan Che, Ph.D., from Zhejiang University in Hangzhou, China, and colleagues examined whether mifepristone is effective and safe for adenomyosis treatment in a multicenter trial conducted in 10 hospitals in China. A total of 134 with adenomyosis pain symptoms were enrolled and randomly assigned to receive mifepristone 10 mg or placebo once a day for 12 weeks. Overall, 126 patients were included in the efficacy analysis: 61 and 65 in the mifepristone and placebo groups, respectively.

The researchers found that the mean change in visual analog scale score after 12 weeks of treatment was −6.63 in the mifepristone group and −0.95 in the group. The total remission rates for dysmenorrhea were significantly better in the mifepristone versus (effective remission: 91.8 versus 23.1 percent; complete remission: 88.5 versus 6.2 percent).

Significant improvements were seen in all secondary end points in the mifepristone group, including menstrual blood loss, hemoglobin, CA125, platelet count, and uterine volume. No significant difference was seen between the groups in the safety analysis, and there were no reports of serious adverse events.

"Adenomyosis-associated dysmenorrhea intensity was significantly reduced after treatment. Regardless of how severe the intensity of dysmenorrhea, the total efficacy for dysmenorrhea was satisfactory," the authors write. "Further research is still needed to determine the long-term safety and efficacy."

More information: Xuan Che et al, Effect of Mifepristone vs Placebo for Treatment of Adenomyosis With Pain Symptoms, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.17860

Journal information: JAMA Network Open