Clinical Applications of Mifepristone (RU486) and Other Antiprogestins Assessing the Science and Recommending a Research Agenda (1993) / Chapter Skim
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INtroduction
INtroduction
Pages 14-18
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From page 14... ...
The desirability of finding precisely defined targets for the interruption of the reproductive process, with unambiguously understood consequences, has remained an elusive goal that continues to occupy the attention of many in the scientific and medical communities, and to a certain extent in the pharmaceutical industry (IOM, 1990~. The discovery that hormones bind to specific receptors before acting on their target cells provided new opportunities for circumscribed 14
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From page 15... ...
This experience underlines the belated recognition that seemingly fundamental reproductive processes in different mammalian species such as ovulation, the recognition and maintenance of pregnancy, and the initiation of labor, are governed by a variety of different control systems and that findings in one species cannot be extrapolated to others and particularly cannot be extrapolated to humans without rigorous verification. Finding an Antiprogestin Although attempts to interfere with the production of progesterone in humans have been without success, the recognition that progesterone, like all other steroids, binds to specific receptors as the first step in its action provided a more precise target for blocking the action of progesterone and thus preventing pregnancy.
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From page 16... ...
While these non-antiprogestational actions of mifepristone may not have particular relevance to its current application as an abortifacient or post-coital contraceptive, they do emphasize the hazard of using mifepristone, or other antiprogestins with mixed activity, as probes in attempts to study the mode and mechanisms of action of progesterone. Less studied than mifepristone are other antiprogestational compounds, produced primarily by Schering AG and Organon.
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From page 17... ...
In this report the committee considers current information and research needed to advance knowledge about the following clinical applications of antiprogestins: intermittent or continuous use to alter the reproductive cycle (contraceptive use) ; use for post-coital contraception; inducing missed menses; pregnancy termination during the first trimester; pregnancy termination and cervical ripening during the second trimester; labor induction in late pregnancy; use as a therapy for endometriosis and uterine leiomyomas; and uses in breast cancer and meningioma therapy.
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From page 18... ...
2. Because antiprogesUns as a class have clear potential for preventive and therapeutic applications in human health beyond those that have already been documented, the committee strongly recommends additional clinical testing of mifepristone and of newer antiprogestins as Hey are developed.
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