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Elagolix: Management for Heavy Menstrual Bleeding Associated with Uterine Fibroids

8 August 2020


Background: Leiomyomas, also known as uterine fibroids, are the most common type of benign tumor in women and the leading cause of hysterectomies in the US. There is currently not an FDA approved long-term pharmacological treatment for excessive menstrual bleeding associated with leiomyomas. Elagolix is an orally active nonpeptide GnRH antagonist, suppressing the pituitary-ovarian axis. The aim of this critically appraised topic is to evaluate the efficacy of elagolix in leiomyoma management.

Methods: An exhaustive literature search using NCBI, CINAHL, and PROQUEST using the search terms “Elagolix”, “leiomyoma”, “menstrual bleeding”, “uterine fibroid”, and “premenopausal” was performed. Evidence was only included if it met eligibility criteria. Inclusion criteria involved premenopausal women experiencing significant menstrual bleeding associated with uterine fibroids. Evidence was excluded if it was not a peer reviewed article within the past 10 years. A risk of bias assessment was performed.

Results: The search yielded a total of 22 results of which 2 adequately addressed the clinical question. These 2 individual studies were randomized controlled trials that demonstrated Elagolix could be a viable option to successfully treat menstrual bleeding from leiomyomas.

Conclusion: Elagolix is a reasonable option to treat heavy menstrual bleeding in premenopausal women with leiomyomas with the addition of an add-back treat


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