The aim of this randomized controlled clinical trial is to evaluate the efficacy of green tea (EGCG) and vitamin D3 supplementation in preventing uterine fibroid recurrence following fibroid removal.
Uterine leiomyomas (fibroids) are the most common benign hormone-dependent tumors affecting approximately 50% to 70% of reproductive-age women. Although many fibroids remain asymptomatic, they may cause abnormal uterine bleeding, pelvic pain, anemia, and infertility. Myomectomy is an effective uterus-preserving surgical treatment; however, fibroid recurrence following surgery remains common, and there is currently no established medical strategy for recurrence prevention. This randomized, double-blind, placebo-controlled clinical trial will evaluate the efficacy of Epigallocatechin gallate (EGCG) and vitamin D3 supplementation in preventing fibroid recurrence following myomectomy. EGCG and vitamin D3 have demonstrated antifibrotic, anti-inflammatory, and antiproliferative properties in preclinical and clinical studies and may represent a potential non-hormonal preventive approach. Premenopausal women undergoing myomectomy for symptomatic uterine fibroids will be randomized into two groups in a 2:1 ratio to receive either (1) daily oral EGCG (300 mg) and vitamin D3 (2000 IU), or (2) placebo, in addition to standard post-surgical care. The intervention period will continue for 24 months following surgery. The primary outcome is fibroid recurrence, assessed by transvaginal ultrasound during scheduled follow-up visits postoperatively. Secondary outcomes include fibroid volume, symptom recurrence, quality-of-life measures, and need for reintervention. Follow-up assessments will include symptom evaluation, questionnaire completion, medication compliance assessment, concomitant medication review, adverse event monitoring, ultrasound evaluation, and predefined safety laboratory investigations according to the study schedule. Statistical analyses will evaluate recurrence rates and treatment efficacy between groups. The results of this trial will provide evidence regarding the effectiveness of EGCG and vitamin D3 as a potential non-hormonal strategy for the prevention of uterine fibroid recurrence following myomectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
240
EGCG and Vitamin D3 (300 mg, 2000 IU respectively, in tablets Each tablet will contain 150 mg EGCG, 1000 IU Vitamin D
The placebo has no medication and the participant will receive standard of care.
Sheikh Shakbhout Medical City
Abu Dhabi, United Arab Emirates (uae), United Arab Emirates
RECRUITINGFibroid Recurrence
The primary outcome is: Fibroid recurrence when compared to the post-myomectomy baseline pelvic ultrasound (transvaginal and/or transabdominal), defined as a new fibroid identified on ultrasound with volume \>1 cm3.
Time frame: 2 years
Return of moderate to heavy menses
Return of moderate to heavy menses defined as PBAC score ≥ 120 for patients with pre-operative moderate to heavy menses. PBAC stands for Pictorial Blood Loss Assessment Chart. In this chart, there is no unit. In this Chart, the higher the number, the heavier the menses.
Time frame: 2 years
Need for reintervention
Need for reintervention defined as the need to undergo a procedure or surgery for treatment of uterine fibroids including repeat myomectomy, uterine fibroid embolization, and radiofrequency ablation. In this outcome, we will examine the participant info at each evaluation visit to capture the data if she has undergone any anti-fibroid procedure or surgery. The captured data will be: "Yes" or "No".
Time frame: 2 years
Time to event
Time to event (procedure or surgery) such as radiofrequency ablation (RFA), myomectomy, hysterectomy, or uterine fibroid embolization (UFE). The unit for this outcome is "weeks". In this outcome, we will examine the patient info at each evaluation visit to calculate the number of "weeks" it took a participant to need to undergo an anti-fibroid procedure or surgery.
Time frame: 2 years
Symptom recurrence
Symptom recurrence according to the Uterine fibroid quality of life symptoms severity subscale. There is no unit for this outcome. Higher score values are indicative of greater symptom severity and lower scores will indicate minimal symptom severity.
Time frame: 2 years
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Return of pelvic pain
Return of pelvic pain during menses as measured on the validated Numerical Rating Scale. There is no unit for this outcome. Higher scores will be indicative of greater pain.
Time frame: 2 years
Uterine Fibroid-related Quality of life
Quality of life as measured by Patient Reported Outcome and validated Quality of life questionnaire (UFS-QOL stands for Uterine Fibroid Symptoms-Quality of Life). There is no unit for this outcome. Higher scores will be indicative of better quality of life.
Time frame: 2 years