Ryeqo is a hormone based oral medication with 3 ingredients. It can be used to alleviate fibroid related heavy menstrual bleeding.
The first ingredient is the GnRHa relugolix, which inhibits the release of pituitary stimulating hormones, thus reduces oestrogen and progesterone production from the ovaries. The second ingredient is an oestrogen to alleviate menopause-like symptoms and prevent osteoporosis. The third ingredient is a progestogen to protect the endometrium.
It is shown to be effective for reducing menstrual bleeding and around 50% women will not have a period towards the end of the 6-month treatment. The medication needs to be taken daily and indefinitely to maintain symptom control. The common side effects are hot flushes, headache and raised blood pressure. Ryeqo is not on the PBS yet and the cost is estimated to be $135 per month.
However, trial studies showed an insignificant fibroid volume loss of only 12% at 6 months. The drug is far less effective in shrinking fibroids comparing with UFE (uterine fibroid embolisation), which on average will shrink fibroid volume by 60% at 6 months.https://www.sydneyfibroidclinic.com.au/fibroids/case-studies/
Fibroids requires the presence of oestrogen and blood supply to grow. Shutting down blood supply to shrink fibroids by embolisation is a far more effective and an once-for-all treatment, preferable by some women, over taking hormone pills forever.
In summary, Ryeqo is a combination hormone based oral treatment that can alleviate heavy menstrual bleeding but is not very effective in shrinking fibroids.
References:
Ryeqo for the treatment of the symptoms of uterine fibroids by Steve Chaplin in Prescriber January 2023
Liberty 1 and Liberty 2 Trials in N Engl J Med 2021
https://www.nejm.org/doi/full/10.1056/NEJMoa2008283#
Ryeqo for endometriosis: What is Ryoq0 by RACCG
https://www1.racgp.org.au/newsgp/clinical/what-is-ryeqo#:~:text=It’s%20costly%20for%20now&text=While%20the%20maker%20has%20made,for%20a%20one%2Dmonth%20supply.