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• W1973192921 abstract "RU 486 is the first antiprogesterone to be used clinically. It inhibits the action of the hormone at the receptor level in target tissues. Its action is particularly significant in the endometrium where it prevents the initiation and progression of pregnancy in the first weeks (contragestive effects). The data indicate that the compound can be used for: voluntary interruption of pregnancy between 6 and 10 weeks, induction of menstruation during the fifth week of amenorrhea, and post-coital contraception. Current trials include its use as a once-a-month menses inducer. It can also be utilized for therapeutic interruption at a late stage of pregnancy, and tried as adjuvant treatment in some case of breast cases. The data on RU 486 have been obtained through studies in physio-pharmacological endocrinology and biochemistry. The development of this antihormone represents a concerted research effort between biology and medicine.RU 486 steroid, the 1st antiprogesterone which may be used in human therapy, prevents the hormone action by taking its place at the receptor level in target cells. It is a norethindrone derivative of the historical progestagen of oral contraception. Its affinity for the progesterone receptor is high, it is orally active, and toxicology studies fail to show any other effects than the endocrine consequences which may be expected from an antihormone. Consequently, it can be tested as a contragestive agent, putting emphasis on the fact that a few hours interruption of the progesterone action prevents pregnancy. At the Department of Obstetrics and Gynecology at the Geneva Hospital Cantonal, women who had asked to terminate 6-10 week pregnancies were administered 200 mg RU 486 to be taken orally for 4 days. The present results concern several hundred pregnancy terminations. With RU 486 alone, a unique dose of less than 400-600 mg, given in the evening, was more efficient than 50-200 mg/day for 3-7 days as in the initial trials. The results were particularly satisfactory when the compound was administered within the days following the assumed date of menstruation (5th week of amenorrhea). Several cases of normal pregnancies have been reported after using RU 486, including 1 as early as the following month. The analysis of the RU 486 mechanism of action showed that the blockage of the progesterone activity on decidualized endometrium causes the detachment of the embryo, resulting in a drop in hCG and secondary luteolysis. Then, prostaglandins are produced, as in laboratory animals, thus increasing contractility of the uterine muscles, such property already being used in pregnancy interruption. Thus, the fact of adding on the 4th day of the RU 486 treatment a weak dosage of synthetic prostaglandin equal to 1/6 of that used alone when inducing abortions made a clear improvement in the results possible. Trials have shown the feasibility of using RU 486 as a means of postcoital contraception. The monthly use of RU 486, at each cycle, of RU 486 as a menses-inducer for women who have regular coitus, is still under study. A study as to how much and for how long RU 486 is to be prescribed should make it possible to define conditions for maintaining a regular menstrual cycle. Conversely, other trials may lead to the use of RU 486 to monitor or suppress ovulation. RU 486 also makes it possible to provoke the therapeutic abortion of dead or abnormal fetuses, even at a late date. It is better tolerated than the oxytocic drugs now used." @default.
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• W1973192921 date "1986-11-01" @default.
• W1973192921 modified "2023-09-23" @default.
• W1973192921 title "Fertility control in women: Results with RU 486 by the end of 1985" @default.
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• W1973192921 doi "https://doi.org/10.1016/0022-4731(86)90315-8" @default.
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