Relevant bibliographies by topics / Mifepristone

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Academic literature on the topic 'Mifepristone'

Author: Grafiati
Published: 4 June 2021
Last updated: 30 July 2024

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Journal articles on the topic "Mifepristone"

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Moraitis, Andreas G., and Richard J. Auchus. "Mifepristone Improves Octreotide Efficacy in Resistant Ectopic Cushing’s Syndrome." Case Reports in Endocrinology 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/8453801.

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A 30-year-old Caucasian man presented with severe Cushing’s syndrome (CS) resulting from ectopic adrenocorticotropin syndrome (EAS) from a metastatic pancreatic neuroendocrine tumor. The patient remained hypercortisolemic despite treatment with steroidogenesis inhibitors, chemotherapy, and octreotide long-acting release (LAR) and was enrolled in a 24-week, phase 3 clinical trial of mifepristone for inoperable hypercortisolemia. After mifepristone was added to ongoing octreotide LAR treatment, EAS symptoms essentially resolved. Cortisol decreased dramatically, despite mifepristone’s competitive glucocorticoid receptor antagonist effects. The clinical and biochemical effects reversed upon mifepristone discontinuation despite the continued use of octreotide LAR therapy. Substantial improvement in octreotide LAR efficacy with mifepristone use was noted in this patient with ectopic CS, consistent with upregulation of somatostatin receptors previously downregulated by hypercortisolemia.
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LaRoche, Kathryn J., Isabelle N. Labeca-Gordon, and Angel M. Foster. "How did the introduction of mifepristone impact the availability of abortion care in Ottawa? A qualitative study with abortion patients." FACETS 5, no. 1 (January 1, 2020): 559–70. http://dx.doi.org/10.1139/facets-2020-0019.

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In 2017, mifepristone and misoprostol became available for early pregnancy termination as the combination pack Mifegymiso® in Ottawa, Ontario, Canada. We conducted 40 semi-structured telephone interviews with Ottawa residents who had abortions before mifepristone’s introduction ( n = 20) and after mifepristone–misoprostol became available ( n = 20) to explore their experiences obtaining care. We audio-recorded and transcribed all interviews and analyzed these data for content and themes using deductive and inductive techniques. Prior to the introduction of mifepristone, our participants reported obtaining abortion care at two facilities and many faced long wait times. Those who had an abortion after mifepristone became available reported obtaining care from a wider array of providers and few waited more than two weeks. However, several mifepristone–misoprostol users reported having to go through a process that involved as many as 10 health service encounters. Both groups reflected positively on their abortion experiences, but some patients who obtained mifepristone–misoprostol outside of an abortion clinic did not feel as well informed as they would have liked. The introduction of mifepristone appears to have expanded the number of service delivery points and reduced wait times for those seeking abortion care in Ottawa. Identifying ways to expand access to medication abortion information and streamline services appears warranted.
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Kayastha, Sanita, Sunima Mainali, and Ritu Subedi. "Efficacy Study of Mifepristone in Pre-induction Cervical Ripening and Induction of Labour." Nepal Medical College Journal 23, no. 3 (October 17, 2021): 259–63. http://dx.doi.org/10.3126/nmcj.v23i3.40417.

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This study was carried out to see the safety and efficacy of mifepristine as pre-induction cervical ripening agent along with misoprostol in induction of labour. It was a study done from January to June 2020 in Department of Obstetrics and Gynecology, Nepal Medical College Teaching Hospital. Total 120 patients were included in this study. Out of which, 60 women were be kept in test group who were induced by mifepristone and misoprostol and 60 women were kept in control group induced by misoprostol only. Patient characteristics, improvement of bishop score, maternal and neonatal outcome was recorded. Chi- square and T- Test were used to compare the result. Patient characteristics and the Bishop score at zero-hour of both the groups were similar. The mean bishop score 48 hours after use of mifepristine in test group was significantly increased in test group vs control group (P<0.0001). There were total 12(20%) patient who went in to labour with mifepristone only without the use of misoprostol. Total number of normal delivery was more (p value=0.003) and cesarean was less (p=0.013) in test group than in control group. The instrumental delivery in both test and control group were same. The adverse effect and neonatal outcome was similar in both the regime. Thus mifepristone as pre-induction cervical ripening agent is a safe and efficient drug
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East, Honey E., Andreas G. Moraitis, and Joseph K. Belanoff. "ODP322 Impact of Mifepristone on Liver Function and Resolution of Liver Steatosis in Patients with Cushing Syndrome – A Case Study." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A496. http://dx.doi.org/10.1210/jendso/bvac150.1031.

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Abstract Background Hypercortisolism is a recognized cause of non-alcoholic fatty liver disease (NAFLD). Mifepristone (Korlym®, Corcept Therapeutics), a glucocorticoid receptor (GR) antagonist, is FDA-approved for the treatment of hyperglycemia in patients with endogenous Cushing syndrome (CS). Mifepristone has also shown beneficial effects in preclinical models of fatty liver disease, including reduced liver injury, improved insulin sensitivity, and increased plasma adiponectin concentrations. Here, we report the case of a patient with CS and liver steatosis who was treated intermittently with mifepristone. Clinical Case A 36-year-old woman with CS associated with uncontrolled type 2 diabetes mellitus, obesity, major depressive disorder, hyperlipidemia, hypertension, and liver steatosis was intermittently treated with mifepristone for 3 years. Abdominal imaging was performed several times for abdominal pain. Before treatment with mifepristone was initiated, the patient had a body weight of 198 lbs, BMI of 32kg/m 2, HbA1c of 11.5%, and liver steatosis as noted on abdominal imaging with normal liver function tests (ALT: 40 U/L [normal: 6-42 U/L], AST: 30 U/L [normal: 8-36 U/L]). After 16 months, treatment with mifepristone was discontinued secondary to abnormal uterine bleeding. Imaging performed around the time of discontinuation showed resolution of liver steatosis, which was accompanied by significant reductions in LFTs to levels typically seen in healthy volunteers without liver steatosis (ALT: 10 U/L, AST: 17 U/L). The patient's HbA1c had decreased to 6.8%. Imaging performed 7months after mifepristone discontinuation showed recurrence of liver steatosis, LFTs had returned to pre-treatment values (ALT: 42 U/L, AST: 31U/L), and HbA1c had increased to 9.3%. The patient underwent hysterectomy and restarted mifepristone treatment. One year after resumption of mifepristone, imaging showed that liver steatosis had resolved once again, along with a similar reduction in LFTs as observed before (ALT: 16 U/L, AST: 12 U/L). Fourteen months after restart, mifepristone was discontinued again. Labs and imaging performed 10 months after discontinuation showed, as previously, recurrence of liver steatosis along with elevated LFTs (ALT: 100 U/L, AST: 56 U/L). Data from mifepristone's prospective pivotal study (SEISMIC, NCT00569582) of 50 patients with CS also showed a similar reduction in ALT throughout the study, which was reversed during the 6-week discontinuation follow-up phase of the study. This was followed by a repeat reduction when mifepristone was restarted in the extension study (NCT00936741). Conclusion These results suggest that mifepristone is effective in improving liver function and decreasing liver steatosis in patients with endogenous CS, a trend that is also accompanied by improvement in insulin resistance and glycemic control. Presentation: No date and time listed
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Simon, Michelle S. "The Federal Future of Medication Abortion." Indiana Law Review 57, no. 3 (June 10, 2024): 613–63. http://dx.doi.org/10.18060/28359.

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A majority of Americans believe that there should be a right to abortion, at least in some cases. Yet a vocal and determined minority has its sights set on a complete ban on all abortions everywhere in the United States. In many states, these anti-abortion activists have achieved their goal through new laws and limitations enacted in the wake of the Supreme Court’s 2022 decision in Dobbs. Anti-abortion advocates are also challenging the Food and Drug Administration’s regulatory approval of mifepristone, one of the drugs used in medication abortion (also known as medical abortion). The FDA had initially approved mifepristone in 2000. During the COVID-19 pandemic, the FDA also relaxed various dispensing requirements and permitted the medication to be prescribed via telemedicine and delivered by mail. In August 2023, the Fifth Circuit ruled in Alliance for Hippocratic Medicine v. FDA that challenges to mifepristone’s approval were likely time-barred, but that access to the medication should be restricted to those who make in-person visits to a doctor, among other limitations. The case will be appealed to the United States Supreme Court This Article makes three contributions to the national conversation about reproductive rights. First, it evaluates the arguments raised by both sides in Alliance for Hippocratic Medicine. Second, it recommends that mifepristone’s defenders focus on standing arguments if they wish to maintain the status quo. Third, the Article predicts that even if mifepristone’s defenders could persuasively argue that the plaintiffs were not entitled to rely on associational standing, there will be future plaintiffs with standing who are willing to take their place. In a future case, the Court might well find that challenges to the FDA’s initial approval of mifepristone are time-barred, but that the agency unlawfully relaxed dispensing and other requirements. It is almost certain that access to mifepristone will be restricted in the foreseeable future.
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Guevara-Ríos, Enrique, Antonio Luna-Figueroa, Miguel Gutiérrez-Ramos, Félix Dasio Ayala-Peralta, Cesar Carranza-Asmat, Pedro Arango-Ochante, Marcos Espinola-Sánchez, et al. "Estudio comparativo en el manejo médico del aborto terapéutico entre el uso de mifepristone más misoprostol y el uso de misoprostol solo." Revista Peruana de Investigación Materno Perinatal 8, no. 4 (December 18, 2019): 56–65. http://dx.doi.org/10.33421/inmp.2019172.

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Objetivos: Evaluar las diferencias en el manejo médico del aborto terapéutico usando Mifepristone más Misoprostol comparado con el uso de Misoprostol solo. Materiales y métodos: Se realizó un estudio observacional, de cohorte retrospectiva y multicéntrica (Instituto Nacional Materno Perinatal [INMP], Hospital Regional de Pucallpa, Hospital Santa Rosa de Piura y Hospital Regional de Loreto), en gestantes con indicación de aborto terapéutico, según lo establecido en la RM N° 486-2014-MINSA. Las pacientes enroladas en el INMP, al ingreso recibieron 200 mg de Mifepristona y a las 24 horas Misoprostol 800 µg colocado en fondo de saco vaginal posterior al cérvix, seguido de 400 µg vía sublingual, cada 3 horas hasta la expulsión del feto y placenta, siendo el tope 5 dosis por día; las pacientes de los tres hospitales restantes se les administro solo Misoprostol bajo el mismo esquema. Resultados: El tiempo de expulsión del feto se consideró desde la administración de la primera dosis del misoprostol hasta las 24 horas; en el grupo de Mifepristona mas Misoprostol fue del 100% y en el grupo de Misoprostol solo fue del 83% (p = 0.05). La expulsión de la placenta en grupo que uso Mifepristona fue del 96% y en el grupo de Misoprostol solo fue del 83% (p = 0.20). Se presentaron restos endouterinos en el 10% del grupo de mifepristona versus 33% del grupo de solo misoprostol (p = 0.03). El tiempo de expulsión del producto de la concepción fue menor en el grupo de mifepristona con una diferencia de sus medianas de 2.8 horas (p =0.001). Conclusiones: Encontramos que existen diferencias en el manejo médico del aborto terapéutico a favor del uso de Mifepristone más Misoprostol versus el uso de Misoprostol solo, en términos de tasa de éxito, tiempo de inducción al aborto y reacciones adversas o complicaciones.
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&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1171 (September 2007): 20. http://dx.doi.org/10.2165/00128415-200711710-00051.

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&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1135 (January 2007): 23. http://dx.doi.org/10.2165/00128415-200711350-00090.

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&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1159 (July 2007): 22–23. http://dx.doi.org/10.2165/00128415-200711590-00064.

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Henshaw, Richard C., and Allan A. Templeton. "Mifepristone." Drugs 44, no. 4 (October 1992): 531–36. http://dx.doi.org/10.2165/00003495-199244040-00001.

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Dissertations / Theses on the topic "Mifepristone"

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Thong, K. Joo. "Prostaglandins, mifepristone and medical abortion." Thesis, University of Newcastle Upon Tyne, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.308749.

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Ashok, P. W. "Clinical uses of mifepristone for fertility control." Thesis, University of Aberdeen, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.592082.

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Vogel, Kristina I. "The Promise of Mifepristone: Perspectives and Experiences Across Canada." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/35078.

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Despite the decriminalization of abortion in Canada in 1988, women still face many barriers to abortion care. With the registration of Mifegymiso® (mifepristone, or RU486) in Canada in July 2015, there is hope that the gold-standard medication abortion could alleviate some of those barriers women face. In this thesis, I used data from a Canada-wide study exploring women’s abortion experiences by way of in-depth interviews to investigate mifepristone’s potential to alter the abortion care landscape. My thesis is comprised of two articles: one using selections from 174 interviews across five provinces, the other using 13 full interviews from Newfoundland as a case study. These papers suggest that women would be interested in using mifepristone once available in Canada, and identified both benefits of and concerns about this method of early pregnancy termination. Despite many unanswered questions as to how and when Mifegymiso® will become available, the registration of this important abortifacient has the promise to increase access and expand choice for Canadian women. Malgré la décriminalisation de l’avortement en 1988, les femmes font toujours face à des obstacles de soins. Avec l'enregistrement de Mifegymiso® (mifépristone, ou RU-486) au Canada en Juillet 2015, il y a espoir que ce médicament d’avortement pourrait atténuer certains de ces obstacles auxquels les femmes sont confrontées. Dans cette thèse, j'ai utilisé les données d'une étude qui explore les expériences d’avortements des femmes à travers le Canada. Les données ont été récupérer par moyen d’entrevues en profondeur et enquête le potentiel du médicament mifépristone à améliorer le paysage de soins de l’avortement. Ma thèse est composée de deux articles: la première inclue une sélection parmi 174 entrevues dans cinq provinces et la deuxième inclus 13 entrevues comme étude de cas de la province de Terre-Neuve. Ces articles suggèrent que l'intérêt pour la mifépristone pourrait être élevé au Canada après l'intégration de ce médicament, et les femmes perçoivent plusieurs avantages à cette méthode de terminaison prématurée de la grossesse et que les femmes ont certaines préoccupations. Malgré qu'il y ait beaucoup de questions sans réponse quant à la façon et quand Mifegymiso® sera disponible, l'enregistrement de cet important abortif a la promesse d'accroître l'accès et élargir le choix pour les femmes canadiennes.
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LALLAOUI, HAKIMA. "Role de la mifepristone (ru 486) et des muscariniques dans le declenchement de la parturition." Université Louis Pasteur (Strasbourg) (1971-2008), 1992. http://www.theses.fr/1992STR1M164.

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Fiala, Christian. "Improving medical abortion : using mifepristone in combination with a prostaglandin analogue /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-458-9/.

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Urquhart, D. Rennie. "Clinical studies with the antiprogesterone Mifepristone (RU486) in human pregnancy termination." Thesis, University of Aberdeen, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.277383.

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Mifepristone in combination with prostaglandin was given to 135 women requesting legal termination, with up to 63 days of amenorrhoea. Various dosage regimes were employed. A 600mg dose of Mifepristone followed forty eight hours later by a prostaglandin vaginal pessary was as effective as more complex regimes given over a longer period. Complete abortion rates of greater than 90% were achieved (approaching the efficacy of the surgical alternative). The outcome of treatment was not gestation dependent. Treatment was well tolerated, acceptable to women, and associated with a low incidence of psychological morbidity. The only serious complication encountered was a 2.5% incidence of heavy bleeding requiring blood transfusion and emergency curettage. Mifepristone is also a useful cervical priming agent prior to late first trimester surgical termination. In a double blind placebo controlled study, forty women received either placebo or 600mg Mifepristone forty eight hours prior to surgery. In the treated group significant cervical dilatation was induced and significantly less force was required to dilate the cervix to allow the passage of a number 8 Karman curette. Blood loss was also significantly reduced. The treatment was well tolerated by patients. No serious complications were noted. In the second trimester, Mifepristone was given at various time intervals prior to prostaglandin induced abortion. The induction to abortion interval and doses of prostglandin required was significantly reduced in Mifepristone treated patients. There was no apparent advantage in an exposure time to Mifepristone of longer than twenty four hours. Serum hormone changes and the development of uterine activity and increased sensitivity to prostaglandins (as measured by intrauterine pressure recordings) after Mifepristone administration are presented. The results are discussed and incorporated into our understanding of the mechanisms of action of Mifepristone in human pregnancy termination.
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Calderón-Salgado, Esther Lilia. "Effect of progesterone and RU486 on cisplatin resistance in OV2008 and C13 ovarian epithelial cancer cell lines." [Kent, Ohio] : Kent State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1208532125.

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Thesis (M.S.)--Kent State University, 2008.
Title from PDF t.p. (viewed May 21, 2009). Advisor: John R.D. Stalvey. Keywords: ovarian cancer, progesterone, cisplatin. Includes bibliographical references (p. 67-75).
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Sant'Anna, Gabriela dos Santos. "Mecanismos epigenéticos em leiomiomas uterinos e o efeito da mifepristona (RU 486) na expressão gênica dos receptores de progesterona total e B." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/169713.

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Introdução: Leiomiomas uterinos ou miomas são tumores benignos que se desenvolvem no miométrio e acometem cerca de 50% da população feminina. Têm como principais sintomas, sangramento excessivo e dor pélvica inespecífica. Convencionalmente o estrogênio é considerado o responsável pelo início da proliferação tumoral, mas recentes evidências clínicas e bioquímicas sugerem que a progesterona apresenta um papel importante no desenvolvimento desses tumores. Além disso, mecanismos epigenéticos parecem estar envolvidos na etiologia dos leiomiomas uterinos, como a metilação de DNA e acetilação de histonas. Somente nos EUA são realizadas 240 mil histerectomias/ano para tratar essa doença sendo considerado um problema de saúde pública. Frente a esses dados é imprescindível o entendimento dos mecanismos moleculares envolvidos no desenvolvimento desses tumores e a busca de tratamentos menos invasivos. A mifepristona (RU 486), um modulador seletivo dos receptores de progesterona e glicocorticoides, é capaz de diminuir o tamanho dos tumores e amenizar os sintomas associados. Objetivos: verificar se (1) nos tecidos de leiomiomas uterinos e miométrio, os mecanismos epigenéticos como a metilação global do DNA e a acetilação de histonas estão alterados (2) se em cultura primária de leiomioma uterino e miométrio o tratamento com estradiol e progesterona é capaz de modular a expressão gênica dos receptores de progesterona total e B, assim como a atividade das enzimas histona acetiltransferase e desacetilase, e (3) se a mifepristona (RU 486) é capaz de modular diretamente a expressão gênica dos receptores de progesterona total e B após tratamento com os hormônios estradiol e progesterona. Métodos: para análise de metilação global do DNA e acetilação de histonas foram utilizadas 25 amostras teciduais para cada grupo de leiomioma uterino e miométrio oriundos de pacientes submetidas à histerectomia no Hospital de Clínicas de Porto Alegre. A metilação global do DNA e a atividade da enzima histona acetiltransferase foram dosadas pelo método de ELISA e a enzima histona desacetilase por detecção fluorimétrica. Para verificar o efeito dos hormônios sexuais ovarianos e o efeito da mifepristona (RU 486) sobre a expressão gênica dos receptores de progesterona total e B foram realizadas 7 culturas primárias de leiomiomas uterinos e miométrio. Resultados: (1) Foram observadas hipermetilação (P = 0,022) e hipoacetilação (P = 0,04) em leiomiomas uterinos quando comparado ao miométrio. Não houve diferença estatística entre estes tecidos em relação à atividade da histona acetiltransferase. (2) Houve aumento da expressão gênica do receptor de progesterona total em cultura primária de leiomioma uterino quando tratado com estradiol (P = 0,028) e o receptor de progesterona B teve sua expressão aumentada quando tratado com estradiol, progesterona e estradiol + progesterona (P = 0,001). (3) O tratamento com mifepristona (RU 486) na dose de 10-6M não foi capaz de diminuir a expressão gênica dos receptores de progesterona total e B em células de leiomiomas uterinos e miométrio. A atividade da enzima histona desacetilase foi maior nas células de leiomioma uterino quando tratadas com estradiol (P = 0,034) e estradiol + progesterona + RU 486 (P = 0,001) quando comparado às células de miométrio, já a atividade da enzima histona acetiltransferase não foi detectada, devido a sua baixa quantidade. Conclusão: Nesse estudo foi observado uma hipermetilação e hipoacetilação nos tecidos de leiomiomas uterinos. Esses resultados sugerem que mecanismos epigenéticos podem estar contribuindo para a diminuição transcricional de genes relacionados ao funcionamento normal do miométrio e, com isso, colaborando para o crescimento desses tumores. Além disso, nossos resultados sugerem que estradiol e progesterona são capazes de modular a expressão gênica dos receptores de progesterona total e B e o medicamento RU 486 na dose de 10-6M não foi capaz de diminuir diretamente a expressão desses receptores.
Introduction: Uterine leiomyoma, also known as fibroids, is a smooth muscle cell tumor, and is clinically apparent in up to 50% of reproductive-age women. Clinical symptoms include abnormal uterine bleeding and pelvic pain. Estrogen has been considered a primary growth promoter of uterine leiomyoma, however clinical and biochemical evidence has suggested that progesterone plays a critical role in the development of these tumors. Furthermore, epigenetic modifications may be involved with etiology of theses tumors, through DNA methylation and histone acetylation. In the United States, 240.000 hysterectomies/year are performed to treat uterine leiomyomas which is being considered to be a public public health problem. The understanding of molecular mechanisms involved in the development of uterine leiomyoma may provide not only opportunities for a diagnostic, but also generation of novel therapeutic approaches. The mifepristone (RU 486), a synthetic steroid that has affinity for progesterone and glucocorticoid receptors has been reported to induce regression of uterine leiomyoma and reduce the symptoms. Objective: verify if (1) DNA global methylation and histone acetylation patterns are altered in uterine leiomioma tissue compared with myometrium; (2) the treatment with estradiol and progesterone are able to modulated de gene expression of total and B progesterone receptors and histone acetylation patterns in primary culture of uterine leiomyoma cells and myometrium as well as (3) the mifepristone (RU 486) are able to modulate the gene expression of total and B progesterone receptors after the treatment with ovarian steroids hormones. Methods: DNA global methylation and histone acetylation patterns were analyzed in 25 tissue samples from uterine leiomioma and myometrium. The DNA global methylation and the activity of histone acetyltransferase were performed using ELISA method. In order to evaluate histone deacetylase activity fluorimetric detection was used. To verify the effect of estradiol and progesterone on total and B progesterone receptors gene expression, as well as the influence of RU486 on this parameters, seven cultured cells from uterine leiomyoma and myometrium cells were performed. Results: (1) Hypermethylation (p = 0.022) and hypoacetylation (p = 0.04) in uterine leiomioma tissues compared with myometrium were observed. There was no statistic difference between these tissues in histone acetyltransferase activity. (2) We observed increased gene expression of total progesterone receptor in culture cells of uterine leiomyoma when treated with estradiol (p = 0.028). There was an increase of B progesterone receptor mRNA when treated with hormones, estradiol and progesterone (p = 0.001). The treatment with RU 486 was not able to modulate progesterone receptors. The histone desacetilase activity was elevated in uterine leiomyoma cells when treated with estradiol (p = 0.034) and estradiol + progesterone + RU 486 (p = 0.001). The histone acetyltransferase activity was barely detectable. Conclusion: In our study we found hypermethylation and hypoacetylation in uterine leiomyoma tissues suggesting that this process may lead to a decreased transcriptional activity of important genes associated with normal myometrium function contributing to the development of these tumors. Furthermore, our results suggest that ovarian steroids hormones increase progesterone receptors expression, being mifepristone (RU 486) at dose of 10-6M unable to decrease total and B progesterone receptors in uterine leiomyoma cells.
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Breton, Ashley B. "Effects of progesterone and RU486 on the development and expression of adult male sexual behavior and adult gene expression within hypothalamic regions." Laramie, Wyo. : University of Wyoming, 2009. http://proquest.umi.com/pqdweb?did=1954799631&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.

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Correa, Julia Martins Simões. "Tratamento medicamentoso da Doença de Cushing revisão sistemática da literatura e metanálise /." Universidade Estadual Paulista (UNESP), 2018. http://hdl.handle.net/11449/153239.

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Introdução: Existem quatro medicações disponíveis como tratamento complementar da doença de Cushing: pasireotida, cabergolina, cetoconazol e mifepristone. Contudo, não existe um consenso sobre qual medicação é mais efetiva e segura para o controle dessa neoplasia. Objetivo: comparar a segurança e a efetividade destas quatro medicações no controle de indivíduos com doença de Cushing não curados pela cirurgia, recidivados ou que não puderam realizar esse procedimento. Metodologia: para isso foi realizada uma revisão sistemática de acordo com a metodologia da colaboração Cochrane, no qual seriam incluídos estudos randomizados das comparações destas medicações entre si e fossem avaliados como desfechos primários a remissão do hipercortisolismo por meio da normalização do cortisol livre urinário (CLU), melhora na qualidade de vida, frequência de eventos adversos, melhora das comorbidades e sintomas associadas a essa doença. Foram realizadas três estratégias de busca adaptadas as bases eletrônicas de saúde: EMBASE, PubMed e CENTRAL-Cochrane. Os estudos foram selecionados por dois revisores independentes e os dados extraídos a partir de um formulário padronizado. Resultados: Foram incluídos dez estudos randomizados, um comparando cabergolina versus cetoconazol, e nove avaliando doses diferentes do pasireotida, sendo que oito se referiam ao mesmo protocolo de estudo. A normalização do CLU em seis meses de tratamento foi inferior na cabergolina em relação ao cetoconazol (33% versus 62,5%, respectivamente), porém, com uma qualidade da evidência muito baixa, essa diferença não foi significativa (RR: 0,53, IC 95%: 0,15-1,87). Comparando a dose maior do pasireotida (900μg subcutâneo duas vezes ao dia ou 30mg de liberação lenta intramuscular a cada 28 dias) com uma dose menor (600μg ou 10mg), a normalização do CLU em seis e 12 meses foi de 29% vs 21% e 25% vs 24%, respectivamente, a metanálise não mostrou diferença significativa entre os grupos (RR 1,35, IC 95%: 0,85 a 2,14 e RR 1,12, IC 95% 0,15 a 1,87, respectivamente). Quanto a segurança, ambas as doses do pasireotida ocasionaram diabetes mellitus, sem diferença ente os grupos (frequência de 25% vs 24%, RR 1,12 IC 95%: 0,44 a 2,89). Nessa mesma comparação, houve melhora na qualidade de vida, dos sintomas e das complicações associadas, também sem diferença significativa entre as doses. Conclusão: um único estudo comparativo entre duas drogas foi encontrado (cabergolina versus o cetoconazol), e a taxa de normalização do CLU em seis meses não foi significativamente diferente entre os grupos. A comparação de duas doses do pasireotida (uma dose maior versus uma menor) em seis meses, sem ajuste de dose e 12 meses com ajuste também não foi significativamente diferente. Em relação à segurança, em 12 meses de seguimento, o evento adverso Diabetes Mellitus ocorreu em 25% dos pacientes que utilizaram o pasireotida. Para todos esses achados a qualidade da evidência de acordo com o GRADE (Grading of Recommendations Assessment, Development, and Evaluation foi baixa.
There are four medications available for the medical treatment of Cushing’s disease: pasireotide, cabergoline, ketoconazole and mifepristone. However, there is no consensus as to the most effective or safe medication. Objective: The aim of this systematic review was to compare these four medications in patients with Cushing’s disease who did not achieve disease control after transsphenoidal surgery, in recurrence cases, or in individuals no candidate for surgery. Methodology: We performed a systematic review according to Cochrane collaboration to include randomized studies comparing these four medications. The primary outcomes were normalization of urinary free cortisol (UFC), quality of life, adverse events and improvement of comorbidities and symptoms related to this condition. Search strategies were applied to the following electronic database: Medline, EMBASE and CENTRAL - Cochrane. Studies were selected by two independent reviewers and data were extracted using a standard form. Results: Ten studies were included, one that compared cabergoline versus ketoconazole, and nine that performed indirect comparisons between two different dosages of pasireotide, although eight referred to the same study protocol. Normalization of UFC in six months of treatment with cabergoline was worst than with ketoconazole (33% versus 62.5%, respectively). However, in the meta-analysis this difference was not statistically significant (RR: 0.53, 95% CI: 0.15- 1.87). Pasireotide 900μg/30mg when compared to pasireotide 600μg/10mg to the normalization of UFC in six and 12 months, presented cure rates of 29% vs 21% e 25% vs 24%, respectively. The meta-analysis did not show significant difference between the groups in six (RR: 1.35 95%CI: 0.85 a 2.14) and in 12 months (RR: 1.12, 95%CI 0.15 a 1.87). Concerning safety, including both groups, 25% of patients using pasireotide presented Diabetes Mellitus without significant difference between the groups (RR: 1.12 95%CI (0.44 a 2.89). Pasireotide was associated with improvement of quality of life, symptoms and comorbidities, although with non-significant differences between dosages. Conclusion: we found a single comparative study between two drugs (cabergoline versus ketoconazole), and the UFC normalization rate at six months was not significantly different between the groups. The comparison of two doses of pasireotide (one higher versus one lower dose) at six months, no dosis adjustment, and 12 months after dosis adjustment was also not significantly different. Regarding safety, at 12 months of the follow-up, the adverse event Diabetes Mellitus occurred in 25% of the patients who used pasireotide. For all these findings the quality of evidence according to GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was very low.
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Books on the topic "Mifepristone"

1

International Society of Gynecological Endocrinology. RU 486 principales données bibliographiques cliniques. Brussels, Belgium: International Society of Gynecological Endocrinology, 1989.

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Cominsky, Karl J. Abortion and RU-486--Mifepristone: Index of new information and research bible. Washington, D.C: Abbe Publishers Association of Washington, D.C., 1995.

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H, Miles Steven, ed. RU-486: New issues in the American abortion debate. Minneapolis, MN: Center for Biomedical Ethics, 1990.

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Costa, Caroline De. RU-486: The abortion pill. Salisbury, Qld: Boolarong Press, 2007.

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United States. Congress. House. Committee on Small Business. Subcommittee on Regulation, Business Opportunities, and Energy. The safety and effectiveness of the abortifacient RU486 in foreign markets: Opportunities and obstacles to U.S. commercialization : hearing before the Subcommittee on Regulation, Business Opportunities, and Energy of the Committee on Small Business, House of Representatives, One Hundred Second Congress, first session, Washington, DC, December 5, 1991. Washington: U.S. G.P.O., 1992.

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International Symposium on Antiprogestins (1992? Bangladesh Association for Prevention of Septic Abortion). Proceedings of the International Symposium on Antiprogestins. Dhaka: Bangladesh Association for Prevention of Septic Abortion, 1992.

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Lee, Sile. Apples like broken glass / decisive. New York, NY?: The author, 2008.

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Chalker, Rebecca. A woman's book of choices: Abortion, menstrual extraction, RU-486. New York: Four Walls Eight Windows, 1992.

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United States. Congress. House. Committee on Small Business. Subcommittee on Regulation, Business Opportunities, and Technology. RU-486, status report on the U.S. commercialization project, transfer of antiprogestin technology to the United States: Hearing before the Subcommittee on Regulation, Business Opportunities, and Technology of the Committee on Small Business, House of Representatives, One Hundred Third Congress, second session, Washington, DC, May 16, 1994. Washington: U.S. G.P.O., 1994.

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United States. Congress. House. Committee on Small Business. Subcommittee on Regulation, Business Opportunities, and Technology. RU-486, status report on the U.S. commercialization project, transfer of antiprogestin technology to the United States: Hearing before the Subcommittee on Regulation, Business Opportunities, and Technology of the Committee on Small Business, House of Representatives, One Hundred Third Congress, second session, Washington, DC, May 16, 1994. Washington: U.S. G.P.O., 1994.

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Book chapters on the topic "Mifepristone"

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Khomasuridze, Archil. "Mifepristone for Postcoital Contraception." In Reproductive Medicine for Clinical Practice, 149–53. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-78009-2_12.

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Wu, Justine. "Medication Abortion Using Mifepristone and Misoprostol." In Primary Care Procedures in Women's Health, 347–62. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-76604-1_26.

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Amico, Jennifer, and Anna Sliwowska. "Medication Abortion Using Mifepristone and Misoprostol." In Primary Care Procedures in Women's Health, 329–41. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-28884-6_27.

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Baulieu, Etienne, and André Ulmann. "RU 486 (Mifepristone): Clinical Update, April 1985." In The Antiprogestin Steroid RU 486 and Human Fertility Control, 347. Boston, MA: Springer US, 1985. http://dx.doi.org/10.1007/978-1-4684-1242-0_32.

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Waring, Eveline, and Beatrice Hull. "Inappropriate Use of Mifepristone to Treat Diabetes Mellitus." In Management of Patients with Pseudo-Endocrine Disorders, 227–34. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-22720-3_18.

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Neulen, J., W. Bernart, M. Kamel, and M. Breckwoldt. "Zur Wirkung von Mifepristone auf das Corpus luteum." In Gießener Gynäkologische Fortbildung 1993, 161–65. Berlin, Heidelberg: Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78349-4_17.

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Patange, R. P., and Kedar Deshmukh. "Comparative Study Between Mifepristone and Dinoprostone Gel for Cervical Ripening and Induction of Labour." In Advancements in Science and Technology for Healthcare, Agriculture, and Environmental Sustainability, 573–78. London: CRC Press, 2024. http://dx.doi.org/10.1201/9781032708348-86.

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Okpara, F. N., E. O. Nwaichi, and D. C. Belonwu. "Triclisia Subcordata Oliv Aqueous Leaf Extract can influence Reproductive Hormones and Haematological Profiles of Mifepristone Threatened Pregnancy in Wistar Rats." In Proceedings of the 6th Biennial Conference of Organization for Women in Science for the Developing World Nigeria (OWSD Garden City 2023), 99–136. Dordrecht: Atlantis Press International BV, 2023. http://dx.doi.org/10.2991/978-94-6463-306-1_7.

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Jeremy, Jamie Y., and Paresh Dandona. "RU 38486 (Mifepristone) Reverses Progesterone- and Hydrocortisone- Mediated Inhibition of Prostanoid Synthesis in Cultured Myometrial, Vascular and Gut Tissue Explants." In Receptor Mediated Antisteroid Action, edited by M. K. Agarwal, 99–120. Berlin, Boston: De Gruyter, 1987. http://dx.doi.org/10.1515/9783110846935-006.

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"Mifepristone." In Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions, 2344–46. Elsevier, 2006. http://dx.doi.org/10.1016/b0-44-451005-2/00967-0.

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Conference papers on the topic "Mifepristone"

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Gaitatzi, F., D. Deuteraiou, X. Anthoulaki, I. Babageogaka, and P. Tsikouras. "Emergency contraception with mifepristone." In 62. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe – DGGG'18. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1671388.

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Brandhagen, BreeAnn N., Chelsea R. Tieszen, Carlos M. Telleria, and Alicia A. Goyeneche. "Abstract 2362: Antimetastatic potential of the antiprogestin mifepristone in cancer cells." In Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL. American Association for Cancer Research, 2011. http://dx.doi.org/10.1158/1538-7445.am2011-2362.

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Wempe, Stacy L., Carlos D. Gamarra-Luques, and Carlos M. Telleria. "Abstract 2098: Synergistic lethality of mifepristone and LY294002 in ovarian cancer cells." In Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/1538-7445.am2013-2098.

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Vottero, Lucía, Claudia Lanari, and Victoria T. Fabris. "Abstract 5828: Effect of Roscovitine and mifepristone in luminal breast cancer cells." In Proceedings: AACR Annual Meeting 2020; April 27-28, 2020 and June 22-24, 2020; Philadelphia, PA. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.am2020-5828.

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Check, Jerome H., Diane Check, Trina Poretta, James Aikins, and Carrie Wilson. "Abstract 696: Palliative benefits of oral mifepristone treatment for metastatic fibroblastic osteosarcoma." In Proceedings: AACR Annual Meeting 2020; April 27-28, 2020 and June 22-24, 2020; Philadelphia, PA. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.am2020-696.

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Freeburg, Elizabeth M., Alicia A. Goyeneche, and Carlos M. Telleria. "Abstract 1210: Mifepristone abrogates repopulation of ovarian cancer cells in between courses of cisplatin treatment." In AACR Annual Meeting--Apr 12-16, 2008; San Diego, CA. American Association for Cancer Research, 2008. http://dx.doi.org/10.1158/1538-7445.am2008-1210.

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Rubin, Ayelen, Veronica de la Fuente, Edgardo Salvatierra, Silvia Vanzulli, Osvaldo Podhajcer, Claudia Lanari, and Paola Rojas. "Abstract 4912: Effect of the combined treatment with mifepristone and chemotherapy on breast cancer brain metastases." In Proceedings: AACR Annual Meeting 2017; April 1-5, 2017; Washington, DC. American Association for Cancer Research, 2017. http://dx.doi.org/10.1158/1538-7445.am2017-4912.

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Zhou, Haiying, Nadine Jachan, Mallika Singh, Chris Tran, Dan McWeeney, Minna Balbas, Emily Schenkein, et al. "Abstract 4172: Activation of AR signaling by mifepristone enhances prostate cancer growth and impairs enzalutamide response." In Proceedings: AACR Annual Meeting 2017; April 1-5, 2017; Washington, DC. American Association for Cancer Research, 2017. http://dx.doi.org/10.1158/1538-7445.am2017-4172.

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Luques, Carlos Gamarra, and Carlos M. Telleria. "Abstract A113: Enhancement of the lethality of platinum-based therapy by antiprogestin mifepristone in ovarian cancer." In Abstracts: AACR International Conference on the Science of Cancer Health Disparities‐‐ Sep 30-Oct 3, 2010; Miami, FL. American Association for Cancer Research, 2010. http://dx.doi.org/10.1158/1055-9965.disp-10-a113.

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Norman, Wendy, Liz Darling, Janusz Kaczorowski, Sheila Dunn, Laura Schummers, Michael Law, and Kimberlyn McGrail. "Is Medical Abortion Feasible in Primary Care? Regulating Mifepristone as a Normal Prescription: Effect on Abortion Workforce." In NAPCRG 50th Annual Meeting — Abstracts of Completed Research 2022. American Academy of Family Physicians, 2023. http://dx.doi.org/10.1370/afm.21.s1.3602.

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Reports on the topic "Mifepristone"

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dai, xiaoxia, bing liu, juan li, and xiang liu. Clinical effect of mifepristone combined with Guizhi Fuling capsule in the treatment of uterine fibroids：a meta analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, March 2022. http://dx.doi.org/10.37766/inplasy2022.3.0170.

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Szmulewitz, Russell. A Pharmacokinetic/Pharmacodynamic Study of the Glucocorticoid Receptor Antagonist Mifepristone Combined with Enzalutamide in Castrate-Resistant Prostate Cancer. Fort Belvoir, VA: Defense Technical Information Center, December 2014. http://dx.doi.org/10.21236/ada613184.

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Li, Siting, Huimin Li, Caifeng Liu, Chenglin Duanmu, and Zhiguo Wang. Network meta-analysis of 7 kinds of Chinese patent medicine combined with mifepristone in the treatment of uterine fibroids. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0101.

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Huang, Jiaxin, Xueer Lin, and Yawen Zhang. Effects of different dosages of mifepristone on uterine leiomyoma in premenopausal women: a meta-analysis of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2022. http://dx.doi.org/10.37766/inplasy2022.11.0020.

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Yin, Xiaoxiao, Liuqing He, Haofei Xu, Shunping Lou, Ying Tan, Yunqing Wang, and Xinyu Luo. Updating the efficacy and safety of different doses of mifepristone in the treatment of uterine fibroids: a meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2024. http://dx.doi.org/10.37766/inplasy2024.6.0075.

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Missed miscarriage should be treated with mifepristone plus misoprostol rather than misoprostol alone. National Institute for Health Research, November 2020. http://dx.doi.org/10.3310/alert_42588.

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