Abstract
We read with great interest the research letter reported by Zbiri et al.1 which investigated the evolution of the number of patients hospitalised due to uterine fibroids in France in 2019 versus 2020. We believe the reporting of their investigations will raise awareness regarding the impact of policy responses to the COVID-19 pandemic on access to care and health outcomes in patients with uterine fibroids.
Based on their investigations, the number of admissions for uterine fibroids dropped by about 14% in 2020 compared with 2019, which indicates that a large proportion of patients with uterine fibroids were not managed in the hospital setting during the COVID-19 pandemic. As hypothesised by the authors,1 this population of patients was likely to continue receiving outpatient care.
We share the concerns of the authors1 regarding the loss of opportunity of care for these patients during the pandemic with the accompanying risk of complications, including the requirement for hysterectomy, the requirement for blood transfusions, and impaired quality of life. With the removal of ulipristal acetate from the market due to the risk of serious drug-induced hepatitis, patients are essentially left with no pharmacological treatment options other than those employed to reduce heavy menstrual bleeding.2
From the pharmacists’ point of view, we believe expansion of available pharmacological therapies for outpatient treatment of uterine fibroids is of the utmost importance, especially when there is an ever-present possibility for disruption in inpatient care. A recent randomised trial from Iran3 has suggested possible benefits from N-acetylcysteine in patients with uterine fibroids. Although the study showed a significant reduction in fibroid and soft tissue tumour size in the treatment versus placebo group, the conclusions must be interpreted with caution given the small number of patients included (n = 50); we urge performance of large-scale randomised trials to investigate further the potential of this treatment.
Based on their investigations, the number of admissions for uterine fibroids dropped by about 14% in 2020 compared with 2019, which indicates that a large proportion of patients with uterine fibroids were not managed in the hospital setting during the COVID-19 pandemic. As hypothesised by the authors,1 this population of patients was likely to continue receiving outpatient care.
We share the concerns of the authors1 regarding the loss of opportunity of care for these patients during the pandemic with the accompanying risk of complications, including the requirement for hysterectomy, the requirement for blood transfusions, and impaired quality of life. With the removal of ulipristal acetate from the market due to the risk of serious drug-induced hepatitis, patients are essentially left with no pharmacological treatment options other than those employed to reduce heavy menstrual bleeding.2
From the pharmacists’ point of view, we believe expansion of available pharmacological therapies for outpatient treatment of uterine fibroids is of the utmost importance, especially when there is an ever-present possibility for disruption in inpatient care. A recent randomised trial from Iran3 has suggested possible benefits from N-acetylcysteine in patients with uterine fibroids. Although the study showed a significant reduction in fibroid and soft tissue tumour size in the treatment versus placebo group, the conclusions must be interpreted with caution given the small number of patients included (n = 50); we urge performance of large-scale randomised trials to investigate further the potential of this treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 1018-1018 |
| Number of pages | 1 |
| Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
| Volume | 131 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jun 2024 |