• Yutaka Osuga, Kazuaki Enya, Kentarou Kudou, and Hiroshi Hoshiai.
• Department of Obstetrics and Gynecology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
• Fertil. Steril. 2019 Nov 1; 112 (5): 922-929.e2.

ObjectiveTo investigate the efficacy and safety of the oral gonadotropin-releasing hormone receptor antagonist, relugolix, in patients experiencing uterine fibroid-associated pain.DesignPhase 3, multicenter, randomized, double-blind, placebo-controlled study.SettingMedical centers.Patient(S)Premenopausal Japanese women (N = 65) experiencing moderate-to-severe uterine fibroid-associated pain with a maximum Numerical Rating Scale (NRS) score of ≥4 were randomized and completed the study.Intervention(S)Once-daily 40 mg relugolix (n = 33) or placebo (n = 32) for 12 weeks.Main Outcome Measure(S)Primary end point: proportion of patients with a maximum NRS score of ≤1 during the 28-day period before the final dose of study drug. Secondary end points: proportion of patients with no pain (NRS = 0) and percentage of days without pain during the 28-day period before the final dose of study drug; adverse events.Result(S)More patients receiving relugolix versus placebo achieved a maximum NRS score of ≤1 during the 28-day period before the final dose of study drug (57.6% vs. 3.1%). Similarly, more patients receiving relugolix versus placebo achieved a maximum NRS score of 0 (48.5% vs. 3.1%) and experienced more days without pain (96.4% vs. 71.4%). More patients receiving relugolix versus placebo experienced treatment-emergent adverse events (TEAEs; 87.9% vs. 56.3%); however, the rate of treatment discontinuation was low and not different between groups. Most TEAEs were mild to moderate in intensity. TEAEs (≥10%) included hot flush, metrorrhagia, hyperhidrosis, and menorrhagia, consistent with relugolix's mechanism of action, and viral upper respiratory tract infection.Conclusion(S)Relugolix improved uterine fibroid-associated pain and was well tolerated.Clinical Trial Registration NumbersNCT02655224.Japic Clinical Trial InformationJapicCTI-163127.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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