Which selective progesterone receptor modulator is approved in Europe for pre-operative treatment of uterine fibroids and has been associated with progesterone receptor modulator-associated endometrial changes (PAEC)?
- A Mifepristone
- B Asoprisnil
- C Ulipristal acetate ✓
- D Telapristone
Correct answer: C. Ulipristal acetate
Explanation
Ulipristal acetate (Esmya) is the SPRM approved in Europe for intermittent treatment of symptomatic uterine fibroids. It causes PAEC — a specific benign endometrial histological change characterised by cystically dilated glands with non-mitotic epithelium — which can be misinterpreted as endometrial hyperplasia. In 2020, the EMA restricted its use due to rare serious liver injury reports. Mifepristone has anti-progesterone/anti-glucocorticoid activity and is not specifically approved for fibroids.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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