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

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Washington, D. C. 1993 Soft Cover New in None as Issued jacket NEW COPY w/trace wear to corner tips of soft cover. This scientific study of post-coital contraception, with ... emphasis on the "first clinically available antiprogestin, mifepristone (RU 486), " includes the findings of the Institute of Medicine's two-day workshop in Washington [1993]. There are substantial data on cellular and molecular interactions; and on such effects as antiestrogenic, antiglucocorticoid, antitumor, and neonatal. Less data is provided on side-effects like obesity (one reference), and depression (two references). 288 pages with 3 Appendices. Read more Show Less

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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.
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Product Details

  • ISBN-13: 9780309049498
  • Publisher: National Academies Press
  • Publication date: 1/1/1993
  • Pages: 304
  • Product dimensions: 6.02 (w) x 9.12 (h) x 0.76 (d)

Table of Contents

Summary 1
Cross-Cutting Recommendations 2
Uses of Antiprogestins: The Reproductive Cycle 3
Other Potential Therapeutic Uses of Antiprogestins 8
Antiglucocorticoid Effects of Antiprogestins 13
1 Introduction 14
Background and Historical Perspectives 14
The IOM Report 17
Cross-Cutting Recommendations 17
2 Uses of Antiprogestins: The Reproductive Cycle (Part I) 19
Contraception 20
Post-Coital Contraception 22
Menses Induction 23
3 Uses of Antiprogestins: The Reproductive Cycle (Part II) 26
Pregnancy Termination During the First Trimester 26
Pregnancy Termination During the Second Trimester 30
Cervical Ripening 32
Labor Induction in Late Pregnancy 33
Summary 34
4 Other Therapeutic Uses of Antiprogestins 36
Endometriosis 36
Uterine Leiomyomas (Fibroids) 39
Breast Cancer 41
Meningiomas 48
5 Antiglucocorticoid Effects of Antiprogestins 52
Glucocorticoid Function 52
Therapeutic Use of Mifepristone (RU 486) as an Antiglucocorticoid 53
Adverse Antiglucocorticoid Effects of Antiprogestins 55
6 Animals as Models for Studying Antiprogestins 57
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
B1 1993: RU 486 - A Decade on Today and Tomorrow 71
B2 Overview and Background: Mechanism of Action of Antiprogestins 120
B3 The Use of Antiprogestins in the Reproductive Cycle 139
B4 Potential Contraceptive Effects of Antigestogens 148
B5 Use of Antiprogestins Before 63 Days of Amenorrhea 164
B6 Uses of Antiprogestins After 63 Days of Amenorrhea 174
B7 Comments on Session II 183
B8 Use of Antiprogestins in the Management of Endometriosis and Leiomyoma 189
B9 Antiprogestins and the Treatment of Breast Cancer 210
B10 Uses of RU 486 as an Antiglucocorticoid 229
B11 Primate Models for the Study of Antiprogestins in Reproductive Medicine 243
B12 Antiprogestogens: Perspectives from a Global Research Program 253
App. C: Observers at the Workshop on Antiprogestins 278
Index 281
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