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Article ; Online: Experimental and new investigational drugs for the treatment of uterine fibroids.

Evangelisti, Giulio / Ferrero, Simone / Perrone, Umberto / Gustavino, Claudio / Volpi, Eugenio / Izzotti, Alberto / Barra, Fabio

Expert opinion on investigational drugs

2024 , Page(s) 1–12

Abstract: Introduction: Uterine fibroids, the most prevalent benign tumors among reproductive-age women, pose treatment challenges that range from surgical interventions to medical therapies for symptom control. Progestins and estroprogestins effectively manage ... ...

Abstract	Introduction: Uterine fibroids, the most prevalent benign tumors among reproductive-age women, pose treatment challenges that range from surgical interventions to medical therapies for symptom control. Progestins and estroprogestins effectively manage uterine bleeding by suppressing dysfunctional endometrium over fibroids. While GnRH agonists represent a crucial milestone in symptom treatment, their prolonged use results in menopausal-like symptoms and irreversible bone mineral density loss. Advancements in understanding fibroid pathophysiology have prompted the exploration of new compounds to overcome current therapy limitations. Areas covered: This manuscript offers an updated overview of investigational drugs for symptomatic uterine fibroids. Expert opinion: Despite ulipristal acetate's well-established efficacy as a selective progesterone receptor modulator (SPRM) in fibroid treatment, its prescription has declined due to the rare but severe risk of liver damage. Oral GnRH antagonists, like elagolix, relugolix, and linzagolix, with their novel pharmacodynamic properties, are gaining traction in fibroid management, inducing a dose-dependent reduction in circulating sex hormone levels. Ongoing research on natural compounds, such as vitamin D and epigallocatechin gallate (EGCG), presents emerging options for treating uterine fibroids. This evolving landscape reflects the ongoing efforts to improve therapeutic outcomes for individuals with symptomatic uterine fibroids.
Language	English
Publishing date	2024-04-17
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1182884-5
ISSN	1744-7658 ; 0967-8298 ; 1354-3784
ISSN (online)	1744-7658
ISSN	0967-8298 ; 1354-3784
DOI	10.1080/13543784.2024.2343786
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Article ; Online: Rituximab for endometriosis: Unlikely translatability from oncology due to safety concerns?

Barra, Fabio / Perrone, Umberto / Ferrero, Simone / Gustavino, Claudio / Bogliolo, Stefano / Izzotti, Alberto

Journal of reproductive immunology

2023 Volume 158, Page(s) 103967

Abstract: This letter discusses the article "The Effects of Rituximab on Experimental Endometriosis Model in Rats" by Dogan et al., which evaluated the potential therapeutic efficacy of rituximab in an experimental animal model of endometriosis. While the study ... ...

Abstract	This letter discusses the article "The Effects of Rituximab on Experimental Endometriosis Model in Rats" by Dogan et al., which evaluated the potential therapeutic efficacy of rituximab in an experimental animal model of endometriosis. While the study showed promising results in decreasing the volume of endometriotic implants and differences in B-cell count and fibrosis score, rituximab is typically used as a therapy for B lymphocyte malignancies and has potential short-term and long-term side effects. Additionally, animal models for endometriosis have limitations, and novel models are still being developed. Therefore, further preclinical research is necessary to evaluate the safety and efficacy of rituximab as a potential treatment for endometriosis in humans.
MeSH term(s)	Humans ; Female ; Rats ; Animals ; Endometriosis/drug therapy ; Endometriosis/pathology ; Rituximab/therapeutic use ; Rituximab/pharmacology ; Disease Models, Animal ; Endometrium/pathology
Chemical Substances	Rituximab (4F4X42SYQ6)
Language	English
Publishing date	2023-05-21
Publishing country	Ireland
Document type	Letter ; Comment
ZDB-ID	424421-7
ISSN	1872-7603 ; 0165-0378
ISSN (online)	1872-7603
ISSN	0165-0378
DOI	10.1016/j.jri.2023.103967
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Article ; Online: Concerns on ranibizumab and zoledronic acid safety for experimentally treating women with endometriosis.

Barra, Fabio / Ferro Desideri, Lorenzo / Gustavino, Claudio / Ferrero, Simone / Traverso, Carlo Enrico / Nicolò, Massimo

Archives of gynecology and obstetrics

2022 Volume 306, Issue 2, Page(s) 569–570

Abstract: Correspondence to the original research entitled "Effects of ranibizumab and zoledronic acid on endometriosis in a rat model" published by Ozdemir et al. ...

Abstract	Correspondence to the original research entitled "Effects of ranibizumab and zoledronic acid on endometriosis in a rat model" published by Ozdemir et al.
MeSH term(s)	Animals ; Bone Density Conservation Agents/adverse effects ; Diphosphonates/adverse effects ; Endometriosis/drug therapy ; Female ; Humans ; Imidazoles/adverse effects ; Ranibizumab/adverse effects ; Rats ; Zoledronic Acid
Chemical Substances	Bone Density Conservation Agents ; Diphosphonates ; Imidazoles ; Zoledronic Acid (6XC1PAD3KF) ; Ranibizumab (ZL1R02VT79)
Language	English
Publishing date	2022-01-06
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-021-06390-3
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Article ; Online: A review of phase II and III drugs for the treatment and management of endometriosis.

Perrone, Umberto / Evangelisti, Giulio / Laganà, Antonio Simone / Bogliolo, Stefano / Ceccaroni, Marcello / Izzotti, Alberto / Gustavino, Claudio / Ferrero, Simone / Barra, Fabio

Expert opinion on emerging drugs

2023 Volume 28, Issue 4, Page(s) 333–351

Abstract: Introduction: Endometriosis is an estrogen-dependent disease that gives rise to pelvic pain and infertility. Although estroprogestins and progestins currently stand as the first-line treatments for this condition, demonstrating efficacy in two-thirds of ...

Abstract	Introduction: Endometriosis is an estrogen-dependent disease that gives rise to pelvic pain and infertility. Although estroprogestins and progestins currently stand as the first-line treatments for this condition, demonstrating efficacy in two-thirds of patients, a significant portion of individuals experience only partial relief or symptom recurrence following the cessation of these therapies. The coexistence of superficial, deep endometriosis, and ovarian endometriomas, as three distinct phenotypes with unique pathogenetic and molecular characteristics, may elucidate the current heterogeneous biological response to available therapy. Areas covered: The objective of this review is to furnish the reader with a comprehensive summary pertaining to phase II-III hormonal treatments for endometriosis. Expert opinion: Ongoing research endeavors are directed toward the development of novel hormonal options for this benign yet debilitating disease. Among them, oral GnRH antagonists emerge as a noteworthy option, furnishing rapid therapeutic onset without an initial flare-up; these drugs facilitate partial or complete estrogen suppression, and promote prompt ovarian function recovery upon discontinuation, effectively surmounting the limitations associated with previously employed GnRH agonists. Limited evidence supports the use of selective estrogen and progesterone receptor modulators. Consequently, further extensive clinical research is imperative to garner a more profound understanding of innovative targets for novel hormonal options.
MeSH term(s)	Female ; Humans ; Endometriosis/drug therapy ; Endometriosis/complications ; Endometriosis/pathology ; Hormone Antagonists/pharmacology ; Hormone Antagonists/therapeutic use ; Progestins/pharmacology ; Progestins/therapeutic use ; Estrogens/therapeutic use ; Gonadotropin-Releasing Hormone/therapeutic use ; Clinical Trials, Phase II as Topic
Chemical Substances	Hormone Antagonists ; Progestins ; Estrogens ; Gonadotropin-Releasing Hormone (33515-09-2)
Language	English
Publishing date	2023-12-26
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2061369-6
ISSN	1744-7623 ; 1472-8214
ISSN (online)	1744-7623
ISSN	1472-8214
DOI	10.1080/14728214.2023.2296080
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Article ; Online: Fishbone double-layer barbed suture in cesarean section: a help in preventing long-term obstetric sequelae?

Alessandri, Franco / Evangelisti, Giulio / Centurioni, Maria Grazia / Gustavino, Claudio / Ferrero, Simone / Barra, Fabio

Archives of gynecology and obstetrics

2021 Volume 304, Issue 3, Page(s) 573–576

Abstract: Due to the high number of cesarean sections over the last two decades, there has been a growing awareness of the post-surgical obstetric long-term sequelae (i.e., uterine scar defects and abnormal placentation) following this surgical procedure. Knotless ...

Abstract	Due to the high number of cesarean sections over the last two decades, there has been a growing awareness of the post-surgical obstetric long-term sequelae (i.e., uterine scar defects and abnormal placentation) following this surgical procedure. Knotless barbed suture is an absorbable bidirectional and unidirectional monofilament, characterized by the presence of "barbs" along its length. After being introduced in gynecology, the favorable features of the knotless barbed suture, such as the uniform distribution of tensile force, provide the rationale for studying its benefits in obstetric surgery. Recently, our research group has investigated a double-layer barbed suture ("fishbone" suture) for closing the uterine wall during cesarean section by a case-control study, reporting a low incidence of uterine scar defects and a reduced size of defects in women who had developed them (NCT04825821). In the near future, large prospective studies are strongly awaited to investigate reproductive outcomes and long-term sequelae after cesarean section performed with knotless barbed suture.
MeSH term(s)	Case-Control Studies ; Cesarean Section/adverse effects ; Female ; Humans ; Pregnancy ; Suture Techniques ; Sutures/adverse effects
Language	English
Publishing date	2021-06-19
Publishing country	Germany
Document type	News
ZDB-ID	896455-5
ISSN	1432-0711 ; 0932-0067
ISSN (online)	1432-0711
ISSN	0932-0067
DOI	10.1007/s00404-021-06121-8
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Article ; Online: Idiopathic Granulomatous Mastitis: The Importance of Summarizing the Heterogenous Evidence of the Current Literature.

Barra, Fabio / Centurioni, Maria Grazia / Gustavino, Claudio / Alessandri, Franco / Ferrero, Simone

Journal of investigative surgery : the official journal of the Academy of Surgical Research

2021 Volume 35, Issue 3, Page(s) 721–722

MeSH term(s)	Diagnosis, Differential ; Female ; Granulomatous Mastitis/diagnosis ; Granulomatous Mastitis/surgery ; Humans
Language	English
Publishing date	2021-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	639444-9
ISSN	1521-0553 ; 0894-1939
ISSN (online)	1521-0553
ISSN	0894-1939
DOI	10.1080/08941939.2021.1901162
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Article ; Online: Systematic review and meta-analysis on the impact of the levonorgestrel-releasing intrauterine system in reducing risk of ovarian cancer.

D'Alessandro, Gloria / Frigerio, Matteo / Barra, Fabio / Costantini, Sergio / Gustavino, Claudio / Ferrero, Simone

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2021 Volume 156, Issue 3, Page(s) 418–424

Abstract: Background: Ovarian carcinoma (OC) is one of the most widespread tumors in the world and is characterized by low survival rates.: Objective: To determine whether the levonorgestrel-releasing intrauterine system (LNG-IUS) can prevent OC.: Search ... ...

Abstract	Background: Ovarian carcinoma (OC) is one of the most widespread tumors in the world and is characterized by low survival rates. Objective: To determine whether the levonorgestrel-releasing intrauterine system (LNG-IUS) can prevent OC. Search strategy: The literature until December 2020 were systematically reviewed according to the PRISMA Statement for Reporting Systematic Reviews (PROSPERO: CRD42019137957). Selection criteria: Studies assessing the impact of LNG-IUS on the risk of OC were included. Data collection and analysis: Data were extracted independently by two authors to ensure accuracy and consistency. Main results: A total of 34 323 records were obtained, of which three satisfied the inclusion criteria. In total, 1687 events of OC in a population of 20 461 311 person-years were considered. Data pooling revealed that the use of LNG-IUS did not confer a lower risk of OC relative to the never-use of LNG-IUS, with an estimated odds ratio of 0.66 (95% confidence interval 0.41-1.08; I Conclusion: The meta-analysis did not demonstrate a preventive role of LNG-IUS on OC. However, it was carried out on a few papers, and a definitive conclusion on the topic still cannot be drawn. Further studies are indicated in the future to define the impact of LNG-IUS on OC. The meta-analysis carried out on three papers did not demonstrate a preventive role of the levonorgestrel-releasing intrauterine device on ovarian cancer.
MeSH term(s)	Carcinoma, Ovarian Epithelial ; Contraceptive Agents, Female ; Female ; Humans ; Intrauterine Devices, Medicated ; Levonorgestrel ; Ovarian Neoplasms/prevention & control
Chemical Substances	Contraceptive Agents, Female ; Levonorgestrel (5W7SIA7YZW)
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.13737
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Article ; Online: Idiopathic Granulomatous Mastitis: Etiopathogenetic Considerations on a Rare Benign Inflammatory Breast Disease.

Altieri, Michele / Barra, Fabio / Casabona, Federico / Soriero, Domenico / Gustavino, Claudio / Ferrero, Simone

Journal of investigative surgery : the official journal of the Academy of Surgical Research

2020 Volume 34, Issue 9, Page(s) 998–999

MeSH term(s)	Female ; Granulomatous Mastitis/diagnosis ; Granulomatous Mastitis/etiology ; Humans
Language	English
Publishing date	2020-03-23
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	639444-9
ISSN	1521-0553 ; 0894-1939
ISSN (online)	1521-0553
ISSN	0894-1939
DOI	10.1080/08941939.2020.1742403
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Article ; Online: Incidence and ultrasonographic characteristics of cesarean scar niches after uterine closure by double-layer barbed suture: A prospective comparative study.

Alessandri, Franco / Centurioni, Maria Grazia / Perrone, Umberto / Evangelisti, Giulio / Urso, Claudia / Paratore, Marco / Guida, Elisabetta / Nappini, Alice / Gustavino, Claudio / Ferrero, Simone / Barra, Fabio

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2023 Volume 162, Issue 3, Page(s) 895–905

Abstract: Objective: To compare the ultrasonographic features of uterine scars and clinical symptoms after cesarean delivery (CD) using barbed and conventional smooth sutures.: Methods: This case-control study enrolled women who underwent primary CD at 37 ... ...

Abstract	Objective: To compare the ultrasonographic features of uterine scars and clinical symptoms after cesarean delivery (CD) using barbed and conventional smooth sutures. Methods: This case-control study enrolled women who underwent primary CD at 37 weeks of pregnancy or later. The uterus was closed using either double-layer unidirectional barbed suture or conventional double-layer smooth suture. Ultrasound scans of the uterine scar and evaluations of menstrual patterns were performed at 6, 12, and 24 months after surgery. Results: In all, 102 patients underwent uterine closure with barbed suture, while 135 patients underwent smooth suture. At 6 months, patients in the barbed group had a lower incidence of uterine niches (20.2% vs 32.6%) that were also shallower in depth (P < 0.001). Lower incidence of niches was also observed in the barbed group at 12 and 24 months (P = 0.043 and 0.048, respectively). At these two follow-up times, the smooth group had a higher number of patients reporting postmenstrual spotting (P < 0.05) and more postmenstrual spotting days per month (P < 0.050). Conclusion: The use of double-layer barbed suture during CD was associated with a lower incidence of scar niches and a more favorable menstrual pattern compared with the use of smooth suture.
MeSH term(s)	Pregnancy ; Humans ; Female ; Cicatrix/diagnostic imaging ; Cicatrix/epidemiology ; Cicatrix/etiology ; Case-Control Studies ; Incidence ; Prospective Studies ; Uterus/diagnostic imaging ; Uterus/surgery ; Sutures
Language	English
Publishing date	2023-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14744
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Article ; Online: Erythropoietin therapy in a case of neonatal anemia after exposure to natalizumab throughout pregnancy.

Godano, Elisabetta / Barra, Fabio / Allodi, Alessandra / Ferraiolo, Antonella / Laroni, Alice / Novi, Giovanni / Mancardi, Giovanni Luigi / Gustavino, Claudio / Arioni, Cesare

Italian journal of pediatrics

2021 Volume 47, Issue 1, Page(s) 69

Abstract: Background: Natalizumab is a monoclonal antibody approved for the treatment of patients with relapsing-remitting multiple sclerosis. According to the current clinical recommendations, its use during pregnancy should be carefully evaluated only in women ... ...

Abstract	Background: Natalizumab is a monoclonal antibody approved for the treatment of patients with relapsing-remitting multiple sclerosis. According to the current clinical recommendations, its use during pregnancy should be carefully evaluated only in women with highly active disease who plan a pregnancy or have an unplanned pregnancy, after accurate counseling about eventual maternal disease relapse due to therapy suspension. Case presentation: This brief case report describes a case of documented anemia that we observed in a newborn whose mother with relapsing-remitting multiple sclerosis was treated with an extended dosing protocol of natalizumab throughout pregnancy. The newborn received the infusion of erythropoietin every seven days from the fortieth day of life; subsequently, the status of anemia underwent clinical resolution. Conclusions: This case report confirmed that natalizumab can cause disorders of hematopoiesis, including anemia, thrombocytopenia, or pancytopenia, in newborns of patients treated during pregnancy. A multidisciplinary team, including experienced pediatricians and pediatric hematologists, has a critical role in managing newborns delivered by women, being treated with natalizumab for treating relapsing-remitting multiple sclerosis during pregnancy.
MeSH term(s)	Anemia, Neonatal/chemically induced ; Anemia, Neonatal/drug therapy ; Erythropoietin/therapeutic use ; Female ; Humans ; Immunologic Factors/adverse effects ; Infant, Newborn ; Infusions, Intravenous ; Maternal-Fetal Exchange ; Multiple Sclerosis, Relapsing-Remitting/drug therapy ; Natalizumab/adverse effects ; Pregnancy
Chemical Substances	Immunologic Factors ; Natalizumab ; Erythropoietin (11096-26-7)
Language	English
Publishing date	2021-03-23
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2088556-8
ISSN	1824-7288 ; 1720-8424
ISSN (online)	1824-7288
ISSN	1720-8424
DOI	10.1186/s13052-021-01025-4
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