Intervention Review

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Aromatase inhibitors for uterine fibroids

  1. Huan Song1,
  2. DongHao Lu1,
  3. Kate Navaratnam2,
  4. Gang Shi3,*

Editorial Group: Cochrane Gynaecology and Fertility Group

Published Online: 23 OCT 2013

Assessed as up-to-date: 23 OCT 2012

DOI: 10.1002/14651858.CD009505.pub2

How to Cite

Song H, Lu D, Navaratnam K, Shi G. Aromatase inhibitors for uterine fibroids. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD009505. DOI: 10.1002/14651858.CD009505.pub2.

Author Information

  1. 1

    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden

  2. 2

    Institute of Translational Medicine, University of Liverpool, Department of Women's and Children's Health, Liverpool, UK

  3. 3

    West China Second University Hospital, Sichuan University, Department of Obstetrics and Gynecology, Chengdu, Sichuan, China

*Gang Shi, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, 3rd Section of Ren Min Nan Road, Chengdu, Sichuan, 610041, China.

Publication History

  1. Publication Status: New
  2. Published Online: 23 OCT 2013


Characteristics of included studies [ordered by study ID]
Parsanezhad 2010

MethodsRCT duration: 12 weeks, multicentre, 70 participants

Participants70 enrolled: AI group = 35, GnRHa group = 35

Evaluated: AI group = 33, GnRHa group = 27

Age, years: AI group = 30.94, GnRHa group = 31.00

Volume of fibroid (cm3): AI group = 108.18, GnRHa group = 95.29

Diagnosis: intramural uterine fibroid

Including premenopausal women with a single intramural uterine fibroid > 5 cm with abnormal uterine bleeding, unexplained infertility, pelvic pain, dysmenorrhoea and pressure effect, or with a fibroid measuring ≥ 5 cm who had additional fibroid(s) with diameter < 2 cm

Excluding women who had additional fibroid(s) measuring > 2 cm, who were under treatment with any type of E or P more recently than 1 month and with hormonal implant more recently than 3 months or who had a history of a major medical problem and/or previous medical or surgical treatment for fibroids

InterventionsAromatase inhibitor (letrozole) was administered orally (2.5 mg/d), regardless of the day of menstrual period, while the GnRH agonist triptorelin (Diphereline; Ipsen Pharma, Paris, France) was administered IM at a dose of 3.75 mg monthly, starting after complete pretreatment work-up.The length of treatment was 12 weeks

  • Reduction of fibroid volume
  • Occurrence of hot flushes
  • Hormonal changes
  • Ovarian and follicular changes

NotesTrials were performed in teaching hospitals affiliated with Siraz University of Medical Sciebces (Shiraz, Iran) and Diako Teaching Centre, Göttingen University (Bremen, Germany)

Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskRandom table

Allocation concealment (selection bias)Unclear riskUnspecified

Blinding of participants and personnel (performance bias)
All outcomes
High riskNot blind

Blinding of outcome assessment (detection bias)
All outcomes
Low riskAssessor-blind

Incomplete outcome data (attrition bias)
All outcomes
Unclear risk60 randomised women were included in analysis (85.7%); no ITT

Selective reporting (reporting bias)Unclear riskNo prior protocol available

Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Badawy 2012Focused on uterine adenomyosis, not uterine fibroids

Nassar 2009Withdrawn before enrolment