The FIRSTT Study: Comparing Focused Ultrasound and Uterine Artery Embolization for Uterine Fibroids
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- Mayo Clinic
- 入组人数
- 56
- 试验地点
- 6
- 主要终点
- Symptomatic outcomes measured by validated instruments
研究概览
简要总结
The primary goal of this study is to compare the safety and effectiveness of two standard fibroid treatments: MRI guided ultrasound surgery (MRgFUS) and uterine artery embolization (UAE). Both treatments are approved by the Food and Drug Administration (FDA) for women who do not plan to become pregnant.
A second goal of this study is to better understand which symptoms bother women with fibroids the most. Understanding and addressing the symptoms of clinically-significant uterine fibroids is important in order to optimize treatment outcomes and control health care costs.
Women who are eligible to participate in the study, are randomized to one of two treatment arms (UAE or MRgFUS). Women in both arms will receive treatment but will not be able to choose which treatment she will receive.
A comprehensive assessment of symptoms-including experienced pain- will take place at baseline, 6 weeks, and at 6, 12, 24, and 36 months following treatment with UAE and MRgFUS.
详细描述
Uterine fibroids affect up to 70 to 80% of women and about 30% of women are symptomatic. Over 200,000 hysterectomies are performed each year for uterine fibroids in the USA. The direct health care costs attributable to uterine fibroids exceed $2.1 billion annually. Fibroids are reported to cause a number of symptoms including heavy or prolonged menstrual bleeding, pelvic pressure, pain with menses and bowel and bladder dysfunction. However, fibroid symptomatology is incompletely understood. Understanding and addressing the myomas pain are important in optimizing treatment outcomes and controlling health care costs from a societal perspective. This study proposes to optimally characterize symptoms and symptom relief in women with leiomyomas severe enough to seek interventional therapy. Secondly we will characterize a variety of symptoms utilizing standardized instruments for other pelvic diseases and symptoms to optimize comparisons with other disease processes.
Clinical and scientific significance of the studies is high. We look to generate resources which can be used at a later time to assess the biologic and genetic variables affecting treatment outcome and to comprehensively assess the societal economic impact of uterine fibroids and their treatment with UAE and MRgFUS.
Participants will be in the study for up to 36 months following fibroid treatment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 25 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Women able to give informed consent and willing and able to attend all study visits
- •Premenopausal women at least 25 years of age
- •No evidence of High Grade SIL by pap smears or HPV testing within institutional guidelines.
排除标准
- •Women actively trying for pregnancy or currently pregnant
- •Uterine size > 20 weeks
- •Prior myomectomy, UAE, or MRgFUS. Previous hysteroscopic or laparoscopic myomectomy for the removal of only pedunculated leiomyomas (as described in #17, below) will be allowed and evaluated on an individual basis to determine eligibility for treatment.
- •More than 6 fibroids > than 3 centimeters in maximal diameter
- •Allergy to either gadolinium or iodinated contrast
- •Implanted metallic device prohibiting MRI
- •Severe claustrophobia
- •BMI which prohibits subject from fitting in MRI device
- •Severe abdominal scarring precluding safe MRgFUS treatment
- •Active pelvic infection
- •Intrauterine contraceptive device in place at the time of treatment
- •Current use of GnRH agonists or antagonists
- •Unstable medical conditions requiring additional monitoring during the procedure
- •Bleeding diathesis requiring medical treatment
- •Imaging suggestive of malignant disease of uterus, ovary, or cervix
- •Imaging suggestive of only adenomyosis
- •Pedunculated submucosal or subserosal myoma with a stalk less than 25% of the maximal fibroid diameter
研究组 & 干预措施
Focused Ultrasound (MRgFUS)
干预措施: Focused ultrasound (MRgFUS) (Procedure)
Uterine Artery Embolization (UAE)
干预措施: Uterine artery embolization (UAE) (Procedure)
结局指标
主要结局
Symptomatic outcomes measured by validated instruments
时间窗: At baseline, 6 weeks and 6, 12, 24, and 36 months following treatment.
次要结局
- Adverse events following treatment(At baseline, 6 weeks and 6, 12, 24 and 36 months following treatment.)
- Biologic predictors of outcome(Blood sample is obtained at baseline and at 12, 24, and 36 months following treatment)
研究者
Elizabeth A. Stewart
Professor of Obstetrics and Gynecology
Mayo Clinic