Statins and uterine fibroids: Potential for a novel therapeutic approach
Bibliographic record
Abstract
BACKGROUND: Uterine fibroids are the most common benign gynecological tumors, affecting up to 70% of women. Only 25% of women with uterine fibroids are symptomatic. Despite the significant clinical burden, no satisfactory long-term medical therapy is currently available. Definitive management often warrants surgery, which might result in significant morbidity and economic burden. Therefore, there is a growing need for novel and effective medical therapy. Statins have shown broad-reaching pleiotropic effects on uterine fibroids, potentially inhibiting growth, reducing the incidence, and alleviating the symptoms. OBJECTIVES: The current study aims to explore the pathophysiological mechanisms and clinical effects of statins on uterine fibroids. SEARCH STRATEGY: We retrieved relevant studies from PubMed, Cochrane Library, Embase, and ScienceDirect, published up to January 3, 2025. The study selection process was conducted using the semi-automated tool Rayyan. SELECTION CRITERIA: Full-text articles of randomized controlled trials (RCTs), case-control studies, cross-sectional studies, cohort studies, case series, and experimental studies in the English language that describe the pathophysiological mechanisms and clinical effects of statins on uterine fibroids were included. Review articles or book chapters were excluded. DATA COLLECTION AND ANALYSIS: Key study characteristics were organized into predefined tables concerning outcome measures: pathophysiological mechanisms and clinical effects. Data synthesis involved a thematic analysis. A meta-analysis was not performed due to study heterogeneity. Study quality assessment was conducted using the Newcastle-Ottawa Scale (NOS), the Cochrane risk-of-bias (RoB1) tool, and the Quality Assessment Tool for In Vitro Studies (QUIN Tool). MAIN RESULTS: We included 13 studies screening 574 studies from four databases, where eight were laboratory-based experimental studies, four were clinical studies, and one provided data on both. Quality assessment graded the studies as moderate to high quality. Statins exhibited diverse pharmacodynamic effects on leiomyoma cells, including a reduction in estrogen receptor-α (ER-α) levels and activity, alterations in intracellular signaling pathways that regulate cell proliferation, a decrease in extracellular matrix (ECM) production, induction of apoptosis, and improvements in altered cellular mechanotransduction, as well as changes in stemness markers. Clinical studies have demonstrated that statins have a significant impact on reducing fibroid volume and alleviating symptoms associated with fibroids. CONCLUSION: Statins have demonstrated anti-proliferative and pro-apoptotic effects on uterine fibroids, resulting in symptomatic improvement and reduction in fibroid volume in clinical studies. However, given the paucity of evidence, it is challenging to conclude on the comparative efficacy, the most appropriate type of statin, the optimal dosing regimen, and the treatment duration, thereby creating a potential research gap. Therefore, we recommend well-planned prospective studies to establish the role of statins in the management of uterine fibroids.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".