A systematic review including 6 studies with a total of 602 subjects was abstracted in DARE. The authors conclude that nafarelin treatment of women with symptomatic leiomyomas effectively decreases uterine bleeding, improves haematologic parameters, manages symptoms of menometrorrhagia, dysmenorrhoea and pelvic discomfort, reduces uterine and myoma size, and is well tolerated. Reduction in bone mineral density occurs, but levels return to approximately baseline levels within 6 months of treatment discontinuation. Patients can be expected to benefit from pre-operative use of nafarelin. Nafarelin was well tolerated. Hot flushes were the most commonly reported adverse event (range: 38.5 to 100%). The adverse effects of nafarelin were generally reversible after treatment withdrawal.
Comment: The quality of evidence is downgraded by review quality (the literature search was limited and there was no validity assessment of the included studies).