Clinical Applications of Mifepristone (RU 486) and Other Antiprogestins.Assessing the Science and Recommending a Research Agenda

摘要

Although many antiprogestins are under investigation by pharmaceutical companiesfor various therapeutic purposes, mifepristone is the only antiprogestin that has been extensively studied in human beings. It has been most widely studied as a means of nonsurgical abortion in early pregnancy, and has been licensed for that purpose in France, the United Kingdom, and Sweden. Because of the perceived promise of this class of compounds for a variety of therapeutic uses, the Institute of Medicine (IOM) established a committee of seven individuals to assess the state of scientific knowledge about antiprogestins, to clarify what is and is not known about these compounds, and to make recommendations for future research that might lead to improvements over currently available therapies for a variety of conditions. The committee reviewed and assessed the basic and clinical research available on the use of antiprogestins for post-coital contraception, continuous-use contraception, induction of missed menses, first-trimester termination of pregnancy, second-trimester termination of pregnancy, as well as induction of labor, and for the treatment of endometriosis, uterine leiomyomas, meningioma, breast cancer, and Cushing's syndrome.