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Journal articles on the topic 'Mifepristone'

Author: Grafiati

Published: 4 June 2021

Last updated: 30 July 2024

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1

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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2

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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3

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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4

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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5

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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6

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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7

&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1171 (September 2007): 20. http://dx.doi.org/10.2165/00128415-200711710-00051.

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8

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

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9

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

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10

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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11

Brogden, Rex N., Karen L. Goa, and Diana Faulds. "Mifepristone." Drugs 45, no. 3 (March 1993): 384–409. http://dx.doi.org/10.2165/00003495-199345030-00007.

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12

&NA;. "Mifepristone." Reactions Weekly &NA;, no. 372 (October 1991): 6–7. http://dx.doi.org/10.2165/00128415-199103720-00035.

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13

&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1095 (April 2006): 18–19. http://dx.doi.org/10.2165/00128415-200610950-00063.

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14

&NA;. "Mifepristone." Reactions Weekly &NA;, no. 864 (August 2001): 9. http://dx.doi.org/10.2165/00128415-200108640-00023.

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15

&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1259 (July 2009): 22–23. http://dx.doi.org/10.2165/00128415-200912590-00062.

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16

DeHart, Renee M., and M. Shawn Morehead. "Mifepristone." Annals of Pharmacotherapy 35, no. 6 (June 2001): 707–19. http://dx.doi.org/10.1345/aph.10397.

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17

&NA;. "Mifepristone." Inpharma Weekly &NA;, no. 800 (August 1991): 5. http://dx.doi.org/10.2165/00128413-199108000-00012.

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18

&NA;. "Mifepristone." Inpharma Weekly &NA;, no. 803 (September 1991): 6. http://dx.doi.org/10.2165/00128413-199108030-00014.

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19

&NA;. "Mifepristone." Reactions Weekly &NA;, no. 1432 (December 2012): 36. http://dx.doi.org/10.2165/00128415-201214320-00129.

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20

Dunn, Sheila, and Melissa Brooks. "Mifepristone." Canadian Medical Association Journal 190, no. 22 (June 4, 2018): E688. http://dx.doi.org/10.1503/cmaj.180047.

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21

Su, Yu-Ting, Jia-Shing Chen, Kuo-Chung Lan, Yung-Kuo Lee, Tian-Huei Chu, Yu-Cheng Ho, Cheng-Chun Wu, and Fu-Jen Huang. "Direct Effects of Mifepristone on Mice Embryogenesis: An In Vitro Evaluation by Single-Embryo RNA Sequencing Analysis." Biomedicines 11, no. 3 (March 15, 2023): 907. http://dx.doi.org/10.3390/biomedicines11030907.

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The clinical use of mifepristone for medical abortions has been established in 1987 in France and since 2000 in the United States. Mifepristone has a limited medical period that lasts <9 weeks of gestation, and the incidence of mifepristone treatment failure increases with gestation time. Mifepristone functions as an antagonist for progesterone and glucocorticoid receptors. Studies have confirmed that mifepristone treatments can directly contribute to endometrium disability by interfering with the endometrial receptivity of the embryo, thus causing decidual endometrial degeneration. However, whether mifepristone efficacy directly affects embryo survival and growth is still an open question. Some women choose to continue their pregnancy after mifepristone treatment fails, and some women express regret and seek medically unapproved mifepristone antagonization with high doses of progesterone. These unapproved treatments raise the potential risk of embryonic fatality and developmental anomalies. Accordingly, in the present study, we collected mouse blastocysts ex vivo and treated implanted blastocysts with mifepristone for 24 h. The embryos were further cultured to day 8 in vitro to finish their growth in the early somite stage, and the embryos were then collected for RNA sequencing (control n = 3, mifepristone n = 3). When we performed a gene set enrichment analysis, our data indicated that mifepristone treatment considerably altered the cellular pathways of embryos in terms of viability, proliferation, and development. The data indicated that mifepristone was involved in hallmark gene sets of protein secretion, mTORC1, fatty acid metabolism, IL-2-STAT5 signaling, adipogenesis, peroxisome, glycolysis, E2F targets, and heme metabolism. The data further revealed that mifepristone interfered with normal embryonic development. In sum, our data suggest that continuing a pregnancy after mifepristone treatment fails is inappropriate and infeasible. The results of our study reveal a high risk of fetus fatality and developmental problems when pregnancies are continued after mifepristone treatment fails.

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22

Landis, Gary N., Hans S. Bell, Oscar Peng, Brett Bognar, Andy Tong, Tomás D. Manea, Hanmei Bao, Xianlin Han, and John Tower. "Dhr96[1] mutation and maternal tudor[1] mutation increase life span and reduce the beneficial effects of mifepristone in mated female Drosophila." PLOS ONE 18, no. 12 (December 21, 2023): e0292820. http://dx.doi.org/10.1371/journal.pone.0292820.

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Mating and receipt of male Sex Peptide hormone cause increased egg laying, increased midgut size and decreased life span in female Drosophila. Feeding mated females with the synthetic steroid mifepristone decreases egg production, reduces midgut size, and increases life span. Here, several gene mutations were assayed to investigate possible mechanisms for mifepristone action. Drosophila Dhr96 is a hormone receptor, and a key positive regulator of midgut lipid uptake and metabolism. Dhr96[1] null mutation increased female life span, and reduced the effects of mifepristone on life span, suggesting that Dhr96[1] mutation and mifepristone may act in part through the same mechanism. Consistent with this idea, lipidomics analysis revealed that mating increases whole-body levels of triglycerides and fatty-acids in triglycerides, and these changes are reversed by mifepristone. Maternal tudor[1] mutation results in females that lack the germ-line and produce no eggs. Maternal tudor[1] mutation increased mated female life span, and reduced but did not eliminate the effects of mating and mifepristone on life span. This indicates that decreased egg production may be related to the life span benefits of mifepristone, but is not essential. Mifepristone increases life span in w[1118] mutant mated females, but did not increase life span in w[1118] mutant virgin females. Mifepristone decreased egg production in w[1118] mutant virgin females, indicating that decreased egg production is not sufficient for mifepristone to increase life span. Mifepristone increases life span in virgin females of some, but not all, white[+] and mini-white[+] strains. Backcrossing of mini-white[+] transgenes into the w[1118] background was not sufficient to confer a life span response to mifepristone in virgin females. Taken together, the data support the hypothesis that mechanisms for mifepristone life span increase involve reduced lipid uptake and/or metabolism, and suggest that mifepristone may increase life span in mated females and virgin females through partly different mechanisms.

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23

Wang, Jianhua. "Effect of Biodegradable Mifepristone Drug Delivery System on the Ultrastructure and Angiogenesis Related Factors of Adenomyosis Cells." Science of Advanced Materials 16, no. 2 (February 1, 2024): 236–43. http://dx.doi.org/10.1166/sam.2024.4613.

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The aim of this research aimed to analyze the effects of degradable mifepristone nano-drug delivery system (DDS) on the ultrastructure, proliferation, apoptosis, and angiogenesis of adenomyosis cells. Drug-loaded nanoparticles (DNPs) of poly lactic-co-glycolic acid (PLGA) were prepared. The particle size distribution and surface Zeta potential (SZP) of nanoparticles (NPs) were detected. The morphology of NPS was subjected to observation by transmission electron microscope (TEM). Adenomyosis lesion cells were cultured by tissue digestion method, and the cell morphology was observed and identified. The cells were divided into blank control (NC), mifepristone, and mifepristone/PLGA groups. The cell proliferation, ultrastructure, apoptosis, and the expression of Survivin, VEGFR1, and VEGFR2 were detected by MTT, TEM, flow cytometry (FC), and immuno-histochemistry, respectively. The results suggested that the average particle size of mifepristone/PLGA NPs was (185.6±12.9) nm, and the SZP was (−9.5±0.9) mV. It presented the characteristics of circularity, uniform distribution, and smooth surface under TEM. As against the raw drug mifepristone, the release time of mifepristone/PLGA NPs was prolonged, and the drug release rate reached 87.4% at 72 h. As against NC, the cell proliferation rate (CPR) was clearly decreased, the apoptosis rate (AR) was increased, and Survivin, VEGFR1, and VEGFR2 had a decrease in mifepristone and mifepristone/PLGA groups (P <0.05). As against mifepristone group, the CPR was clearly decreased, the AR was increased, and Survivin, VEGFR1, and VEGFR2 had a decrease in mifepristone/PLGA group (P <0.05). In conclusion, mifepristone PLGA DNPs were able to delay drug release. Mifepristone can inhibit angiogenesis and promote apoptosis of adenomyosis by affecting the expression of Survivin, VEGFR1, and VEGFR2, thus playing a role in the treatment of adenomyosis.

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24

Hapangama, Dharani K., Hilary O. D. Critchley, Teresa A. Henderson, and David T. Baird. "Mifepristone-Induced Vaginal Bleeding Is Associated with Increased Immunostaining for Cyclooxygenase-2 and Decrease in Prostaglandin Dehydrogenase in Luteal Phase Endometrium." Journal of Clinical Endocrinology & Metabolism 87, no. 11 (November 1, 2002): 5229–34. http://dx.doi.org/10.1210/jc.2002-020429.

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Abstract The mechanism of mifepristone-induced vaginal bleeding and endometrial shedding was investigated in 13 women who took 200 mg mifepristone in the midluteal phase on d 8 after the onset of the urinary LH surge (LH+8). Endometrial biopsies were collected, 6–24 h after mifepristone (group 1, n = 7) or 36–48 h after mifepristone (group 2, n = 6), and compared with those from a control group in the midluteal phase (n = 7). All women reported vaginal bleeding commencing 36–48 h after taking mifepristone. Treatment with mifepristone significantly reduced serum progesterone levels in all women, when compared with the controls (13.2 nmvs. 34.8 nm, P = 0.001). After mifepristone, a significant increase in cyclooxygenase-2 immunoreactivity was apparent at 36–48 h (P = 0.0018), whereas prostaglandin 15 dehydrogenase enzyme-positive immunostaining declined, to be virtually absent by 36–48 h in both glands and in stroma (P < 0.05). There was no change in intensity or distribution of staining for steroid receptors after mifepristone. The changes in immunostaining for cyclooxygenase-2 and prostaglandin 15 dehydrogenase strongly support the hypothesis that an increase in the local concentration of prostaglandins in the endometrium is involved in the mechanism of bleeding induced by mifepristone in the luteal phase.

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25

Hsieh, Yi-Ping, Yun-Ju Wang, Ling-Yi Feng, Li-Tzy Wu, and Jih-Heng Li. "Mifepristone (RU-486®) as a Schedule IV Controlled Drug—Implications for a Misleading Drug Policy on Women’s Health Care." International Journal of Environmental Research and Public Health 19, no. 14 (July 8, 2022): 8363. http://dx.doi.org/10.3390/ijerph19148363.

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Background: Mifepristone (RU-486) has been approved for abortion in Taiwan since 2000. Mifepristone was the first non-addictive medicine to be classified as a schedule IV controlled drug. As a case of the “misuse” of “misuse of drugs laws,” the policy and consequences of mifepristone-assisted abortion for pregnant women could be compared with those of illicit drug use for drug addicts. Methods: The rule-making process of mifepristone regulation was analyzed from various aspects of legitimacy, social stigma, women’s human rights, and access to health care. Results and Discussion: The restriction policy on mifepristone regulation in Taiwan has raised concerns over the legitimacy of listing a non-addictive substance as a controlled drug, which may produce stigma and negatively affect women’s reproductive and privacy rights. Such a restriction policy and social stigma may lead to the unwillingness of pregnant women to utilize safe abortion services. Under the threat of the COVID-19 pandemic, the US FDA’s action on mifepristone prescription and dispensing reminds us it is time to consider a change of policy. Conclusions: Listing mifepristone as a controlled drug could impede the acceptability and accessibility of safe mifepristone use and violates women’s right to health care.

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26

Golier, Julia A., Kimberly Caramanica, Rebecca DeMaria, and Rachel Yehuda. "A Pilot Study of Mifepristone in Combat-Related PTSD." Depression Research and Treatment 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/393251.

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Background. We obtained pilot data to examine the clinical and neuroendocrine effects of short-term mifepristone treatment in male veterans with PTSD.Methods. Eight male veterans with military-related PTSD completed a randomized, double-blind trial of one week of treatment with mifepristone (600 mg/day) or placebo. The primary clinical outcome measures were improvement in PTSD symptoms and dichotomously defined clinical responder status as measured by the CAPS at one-month follow-up. Additional outcome measures included self-reported measures of PTSD symptom severity, CAPS-2 symptom subscale scores, and morning plasma cortisol and ACTH levels.Results. Mifepristone was associated with significant improvements in total CAPS-2 score. At one-month follow-up, all four veterans in the mifepristone group and one of four veterans in the placebo group achieved clinical response; three of four veterans in the mifepristone group and one of four veterans in the mifepristone group remitted. Mifepristone treatment was associated with acute increases in cortisol and ACTH levels and decreases in cytosolic glucocorticoid receptor number in lymphocytes.Conclusions. Further controlled trials of the effects of mifepristone and their durability are indicated in PTSD. If effective, a short-term pharmacological treatment in PTSD could have myriad uses.

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27

Wempe, Stacy L., Carlos D. Gamarra-Luques, and Carlos M. Telleria. "Synergistic Lethality of Mifepristone and LY294002 in Ovarian Cancer Cells." Cancer Growth and Metastasis 6 (January 2013): CGM.S11124. http://dx.doi.org/10.4137/cgm.s11124.

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We have previously shown that the antiprogestin and antiglucocorticoid mifepristone inhibits the growth of ovarian cancer cells. In this work, we hypothesized that cellular stress caused by mifepristone is limited to cytostasis and that cell killing is avoided as a consequence of the persistent activity of the PI3K/Akt survival pathway. To investigate the role of this pathway in mifepristone-induced growth inhibition, human ovarian cancer cells of various histological subtypes and genetic backgrounds were exposed to cytostatic doses of mifepristone in the presence or absence of the PI3K inhibitor, LY294002. The activation of Akt in ovarian cancer cells, as marked by its phosphorylation on Ser473, was not modified by cytostatic concentrations of mifepristone, but it was blocked upon treatment with LY294002. The combination mifepristone/LY294002, but not the individual drugs, killed ovarian cancer cells via apoptosis, as attested by genomic DNA fragmentation and cleavage of caspase-3, and the concomitant downregulation of antiapoptotic proteins Bcl-2 and XIAP. From a pharmacological standpoint, when assessing cell growth inhibition using a median-dose analysis algorithm, the interaction between mifepristone and LY294002 was synergistic. The lethality caused by the combination mifepristone/LY294004 in 2-dimensional cell cultures was recapitulated in organized, 3-dimensional spheroids. This study demonstrates that mifepristone and LY294002 when used individually cause cell growth arrest; yet, when combined, they cause lethality.

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28

Leminen, Riikka, Taneli Raivio, Sirpa Ranta, Joachim Oehler, Helena von Hertzen, Olli A. Jänne, and Oskari Heikinheimo. "Late follicular phase administration of mifepristone suppresses circulating leptin and FSH – mechanism(s) of action in emergency contraception?" European Journal of Endocrinology 152, no. 3 (March 2005): 411–18. http://dx.doi.org/10.1530/eje.1.01884.

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Objective: Low dose mifepristone (RU486) is highly effective in emergency post-coital contraception (EC), although the mechanism(s) of action remains unclear. We studied the endocrine actions of 10 mg mifepristone administered orally as a single dose to eight healthy volunteers (aged 20–45 years) during the late follicular phase. Methods: Serum levels of LH, FSH, oestradiol, progesterone, leptin, mifepristone, cortisol, and gluco-corticoid bioactivity (GBA) were measured before and 1, 2, 4 and 8 h after ingestion of mifepristone on cycle day 10 or 11 (study day 1), and follow-up was continued for 10 days. Ovarian ultrasonography was performed on study days 1 and 7. Similar measurements were carried out during a control cycle. Results: Mifepristone postponed ovulation, as evidenced by a 3.4±1.1 day (means±s.d.) delay (P < 0.005) in the LH surge and 3.6±4.0 day prolongation of the treatment cycle (P = 0.08). During the mifepristone cycle, an LH surge was displayed by five subjects when serum mifepristone levels had declined to 9.5±7.1 nmol/l. During the day of mifepristone administration, circulating GBA (P < 0.001) and leptin (P < 0.001) levels declined. On the day after mifepristone administration, mean serum FSH and leptin levels were lower than pretreatment values (3.8±1.8 IU/l vs 5.2±1.1 IU/l, n = 7, P < 0.05; 28.9±6.7 μg/l vs 33.2±9.0 μg/l, n = 7, P < 0.05 respectively), and the corresponding difference in the mean serum oestradiol concentration was borderline (452±252 pmol/l vs 647±406 pmol/l, n = 7, P = 0.056). In contrast to the control cycle, individual leptin levels declined during the follow-up after ingestion of mifepristone (n = 8, P < 0.01). Conclusions: These data showed that the commonly employed dose of mifepristone for EC delays ovulation and prolongs the menstrual cycle, when given during the late follicular phase. The mechanism of action of mifepristone may include a reduction of FSH secretion via a decrease in circulating leptin.

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Kravchenko, О. V. "Predictional factors of efficiency of myfipristone in pre-induction cervical ripening." HEALTH OF WOMAN, no. 1(127) (February 28, 2018): 40–42. http://dx.doi.org/10.15574/hw.2018.127.40.

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The objective: to study clinical and ultrasound criteria, which are prognostically important in determining the effectiveness of pre-induction and induction of labor by mifepristone. Materials and methods. 192 patients were examined during the gestation period of 40–42 weeks, with mifepristone (mirapriston) used to prepare the cervix for delivery. The effectiveness of pre-induction preparation of mifepristone was assessed by the following criteria: maturation of the cervix, the need for additional induction methods, the independent initiation of regular labor, the development of abnormalities of labor, the frequency of delivery through the natural birth canal and by cesarean section, neonatal outcomes. Results. It was found that before the reception of mifepristone the cervix was evaluated as «immature» in 59.9% of pregnant women, in 40.1% of patients it was «not mature enough». Self-sustained labor after pre-induction with mifepristone developed in 83.3% of women. 2.6% of pregnant women were operated in a planned manner due to the lack of effect from pre-induction training. In 16.7% of the patients, deliveries ended by an urgent cesarean section. The main prognostic factors for the effectiveness of pre-induction preparation are the length of the cervix, the age of the pregnant woman, the dose ratio of mifepristone and the body weight of the woman. Conclusion. Use of mifepristone is a highly effective method of preparing the body for pregnant women to delivery. The appointment of mifepristone promotes spontaneous development of labor activity in 79.3% of pregnant women. The highest percentage of success in pre-induction with mifepristone was observed with a cervical length of 25 mm or less. The age of a pregnant woman over the age of 30 is a prognostic factor of the less effective mifepristone in preparing the cervix to delivery than before age 30. The dose ratio of mifepristone and the body weight of the patient have great prognostic value as for to the maturation of the cervix and for the characteristics of the course of the normal labor. The use of mifepristone does not lead to a negative effect of the fetal condition and involutive processes of myometrium in postpartum period. Key words: efficacy factors, pre-induction preparation, mifepristone.

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&NA;. "Gemeprost/mifepristone." Reactions Weekly &NA;, no. 552 (May 1995): 8. http://dx.doi.org/10.2165/00128415-199505520-00029.

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&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 607 (June 1996): 8. http://dx.doi.org/10.2165/00128415-199606070-00023.

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&NA;. "Gemeprost/mifepristone." Reactions Weekly &NA;, no. 615 (August 1996): 10. http://dx.doi.org/10.2165/00128415-199606150-00032.

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&NA;. "Mifepristone/sulprostone." Reactions Weekly &NA;, no. 379 (November 1991): 10. http://dx.doi.org/10.2165/00128415-199103790-00049.

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&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 1202 (May 2008): 25. http://dx.doi.org/10.2165/00128415-200812020-00076.

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&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 1225 (October 2008): 18. http://dx.doi.org/10.2165/00128415-200812250-00062.

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36

&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 1081 (December 2005): 19. http://dx.doi.org/10.2165/00128415-200510810-00060.

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&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 1089 (February 2006): 20. http://dx.doi.org/10.2165/00128415-200610890-00063.

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38

Di Pietro, Maria Luisa, and Marina Casini. "Il mifepristone." Medicina e Morale 51, no. 6 (December 31, 2002): 1047–79. http://dx.doi.org/10.4081/mem.2002.680.

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Il contributo trae spunto dalla recente (ottobre 2002) autorizzazione da parte del Comitato Regionale del Piemonte alla sperimentazione del mifepristone – principio attivo della nota pillola abortiva RU486 - presso l’ospedale Sant’Anna di Torino e coglie l’occasione per ripercorrere, nella fase introduttiva, le tappe più significative della storia del mifepristone. L’intento di questo studio, tuttavia, non è né un’indagine storica, né una valutazione delle effettive competenze di un Comitato Etico regionale ad autorizzare una sperimentazione, né una comparazione tra aborto chirurgico e aborto medico, quanto piuttosto dare un’informazione documentata e attenta su aspetti spesso sottaciuti, ma importanti per conoscere a fondo questa moderna modalità di interruzione volontaria di una vita umana in sviluppo dentro il grembo della madre. Vengono pertanto analizzati i dati disponibili in letteratura relativamente agli effetti collaterali, alle complicanze, ai rischi dell’aborto con uso di mifepristone/ misoprostolo e alle ricadute psicologiche per la donna. Vengono, inoltre, prese in esame le problematiche giuridiche del ricorso all’aborto medico ed analizzata l’applicabilità dell’articolo 9 della legge n. 194 del 1978 in materia di obiezione di coscienza.

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&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 1035 (January 2005): 11–12. http://dx.doi.org/10.2165/00128415-200510350-00029.

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&NA;. "Mifepristone/misoprostol." Reactions Weekly &NA;, no. 1352 (May 2011): 28. http://dx.doi.org/10.2165/00128415-201113520-00105.

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&NA;. "Mifepristone + misoprostol." Inpharma Weekly &NA;, no. 816 (December 1991): 9. http://dx.doi.org/10.2165/00128413-199108160-00024.

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&NA;. "MIFEPRISTONE (MIFEPREX)." American Journal of Nursing 100, no. 12 (December 2000): 24AAA. http://dx.doi.org/10.1097/00000446-200012000-00029.

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Mangla, Bhupesh. "Mifepristone opposed." Lancet 342, no. 8864 (July 1993): 170. http://dx.doi.org/10.1016/0140-6736(93)91368-v.

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Pons, Jean-Claude, and Emile Papiernik. "Mifepristone teratogenicity." Lancet 338, no. 8778 (November 1991): 1332–33. http://dx.doi.org/10.1016/0140-6736(91)92629-g.

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Do, Thi Kim Ngoc, and Vu Quoc Huy Nguyen. "TERMINATION OF PREGNANCY LESS THAN 49 DAYS USING MIFEPRISTONE AND MISOPROSTOL." Journal of Medicine and Pharmacy, June 2011, 16–24. http://dx.doi.org/10.34071/jmp.2011.3.3.

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Objectives: 1.To evaluate the effectiveness and safety of Mifepristone and Misoprostol in termination of pregnancy less than 49 days. 2. To evaluate the acceptability and side effects of that treatment scheme. Materials & Methods: 169 pregnant women less than <49 days demanding medical abortion at Can Tho Reproductive Health Center during the period of June 1st 2009 to May 30th 2010. Mifepristone 200mg was administered orally, followed by onsite monitoring during 30 minutes; Misoprostol 400 µg were administered orally 48 hours later by th facility at the center. Follow-up visit for 2 weeks was made after using Mifepristone. Results and Discussion: Rate of successful pregnancy termination was 95.3%. Mean duration between Mifepristone and Misoprostol use and abortion is 4.3 ± 3.7 hours. Satisfaction rate is 89.4%. Observed Mifepristone’s side effects include abdominal pain (35.8%), nausea (20.3%), and vomit (4.8%); Misoprostol’s side effects include abdominal pain (86.6%), nausea (33,7%), vomit (8,6%), fever/child, fatigue and diarrhea (7.5%). Conclusions: Mifepristone and Misoprostol are safe and highly effective for termination of pregnancy less than 49 days.

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"Mifepristone." Reactions Weekly 1853, no. 1 (May 2021): 307. http://dx.doi.org/10.1007/s40278-021-95173-1.

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"Mifepristone." Journal of Obstetrics and Gynaecology Canada 31, no. 12 (December 2009): 1180. http://dx.doi.org/10.1016/s1701-2163(16)34380-8.

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"Mifepristone." Journal of Obstetrics and Gynaecology Canada 25, no. 3 (March 2003): 235. http://dx.doi.org/10.1016/s1701-2163(16)30112-8.

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"Mifepristone." Reactions Weekly 1583, no. 1 (January 2016): 756. http://dx.doi.org/10.1007/s40278-016-13319-9.

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"Mifepristone." Reactions Weekly 1712, no. 1 (July 2018): 365. http://dx.doi.org/10.1007/s40278-018-49654-y.

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