GnRH antagonists have the potential to be a complete long-term alternative to surgery. GnRH antagonists can be used with the hope that surgery, if required, could be avoided or delayed; or they could reduce UF volume and so enable less invasive surgical procedures. These clinical decisions are down to the judgment of their healthcare team and the individual patient’s needs.
All available GnRH antagonists have been approved by the appropriate regulatory bodies (e.g., EMA, FDA) for the treatment of moderate to severe symptoms of UF. There is no limitation to the use of GnRH antagonists, in terms of when or length of use (with the exception of linzagolix 200mg without additional hormonal add-back therapy, which is limited to 6 months’ use).1,2
There may be important differences between GnRH antagonists in terms of how they need to be taken, strategies to avoid hypoestrogenic effects and how reproducible the clinical trial results are in real life.1.2 To date, there have been no directly comparative studies of the different products within the class. Further information on each product’s dosing, efficacy achieved in randomised clinical trials (RCTs), tolerability (including any effect on BMD) and need for any special precautions, warnings or required monitoring will be listed in their approved SmPCs1.2. These may help you decide which are the most viable option for your patients.
