Clinical Applications of Mifepristone (RU486) and Other Antiprogestins: Assessing the Science and Recommending a Research Agenda

Clinical Applications of Mifepristone (RU486) and Other Antiprogestins: Assessing the Science and Recommending a Research Agenda

by Molla S. Donaldson, Laneta Dorflinger, Sarah S. Brown, Leslie Z. Benet
     
 

ISBN-10: 0309049490

ISBN-13: 9780309049498

Pub. Date: 01/15/1993

Publisher: National Academies Press

Mifepristone (RU486), the first clinically available antiprogestin, has generated great interest since its discovery in the early 1980s. Today, it is recognized that mifepristone, along with other antiprogestins, has a potentially significant therapeutic role in human health and disease, with likely applicability to a variety of pregnancy-related conditions (e.g.,

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Overview

Mifepristone (RU486), the first clinically available antiprogestin, has generated great interest since its discovery in the early 1980s. Today, it is recognized that mifepristone, along with other antiprogestins, has a potentially significant therapeutic role in human health and disease, with likely applicability to a variety of pregnancy-related conditions (e.g., management of labor) and to contraception, endometriosis, and cancer, among others. But because mifepristone has been studied and used most widely as a means of nonsurgical abortion, political issues have thus far limited research on the drug and prevented its introduction into the U.S. market.

This book provides an unbiased evaluation of current knowledge about both the fundamental nature of antiprogestins as well as their possible use in treating numerous diseases and conditions, and it contains recommendations for future research.

Product Details

ISBN-13:
9780309049498
Publisher:
National Academies Press
Publication date:
01/15/1993
Pages:
304
Product dimensions:
6.00(w) x 9.00(h) x 0.76(d)

Table of Contents

Summary1
Cross-Cutting Recommendations2
Uses of Antiprogestins: The Reproductive Cycle3
Other Potential Therapeutic Uses of Antiprogestins8
Antiglucocorticoid Effects of Antiprogestins13
1Introduction14
Background and Historical Perspectives14
The IOM Report17
Cross-Cutting Recommendations17
2Uses of Antiprogestins: The Reproductive Cycle (Part I)19
Contraception20
Post-Coital Contraception22
Menses Induction23
3Uses of Antiprogestins: The Reproductive Cycle (Part II)26
Pregnancy Termination During the First Trimester26
Pregnancy Termination During the Second Trimester30
Cervical Ripening32
Labor Induction in Late Pregnancy33
Summary34
4Other Therapeutic Uses of Antiprogestins36
Endometriosis36
Uterine Leiomyomas (Fibroids)39
Breast Cancer41
Meningiomas48
5Antiglucocorticoid Effects of Antiprogestins52
Glucocorticoid Function52
Therapeutic Use of Mifepristone (RU 486) as an Antiglucocorticoid53
Adverse Antiglucocorticoid Effects of Antiprogestins55
6Animals as Models for Studying Antiprogestins57
App. A: Agenda for the IOM Workshop "Antiprogestins: Assessing the Science"65
App. B: Background Papers and Presentations (In Order of Presentation at IOM Workshop)69
B11993: RU 486 - A Decade on Today and Tomorrow71
B2Overview and Background: Mechanism of Action of Antiprogestins120
B3The Use of Antiprogestins in the Reproductive Cycle139
B4Potential Contraceptive Effects of Antigestogens148
B5Use of Antiprogestins Before 63 Days of Amenorrhea164
B6Uses of Antiprogestins After 63 Days of Amenorrhea174
B7Comments on Session II183
B8Use of Antiprogestins in the Management of Endometriosis and Leiomyoma189
B9Antiprogestins and the Treatment of Breast Cancer210
B10Uses of RU 486 as an Antiglucocorticoid229
B11Primate Models for the Study of Antiprogestins in Reproductive Medicine243
B12Antiprogestogens: Perspectives from a Global Research Program253
App. C: Observers at the Workshop on Antiprogestins278
Index281

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