Antiprogestins, agents that inhibit the action of progesterone,are among the most controversial and yet the more interestingtherapeutic compounds developed in the past 20 years. Theseagents provide the most effective and safest means of medicalabortion, and in addition they may be used for the treatmentof patients with cancer, Cushing's syndrome, and gynecologicdisorders and for contraception. The first effective antiprogestinwas mifepristone (also known as RU 486),1 a derivative of theprogestin norethindrone (Figure 1). By analogy with the antiestrogens,it is likely that the substitution at the 11 beta position isresponsible for . . . [Full Text of this Article]
Pharmacology and Metabolism
Antiprogestational Activity
Physiology and Mechanism of Actio
Endometrium
Gonadotropin and Steroid Secretion
Pregnant Uterus
Clinical Usefulnes
Abortion Induced by Mifepristone Alone
Abortion Induced by Mifepristone plus Prostaglandins
Contraception
Cervical Dilatation
Induction of Labor
Other Gynecologic Indications
Breast Cancer
Meningioma
Antiglucocorticoid Activity
Physiology
Antiglucocorticoid Application
Untoward Effects
Conclusions
Source Information
From the Center for Biomedical Research, the Population Council, 1230 York Ave., New York, NY 10021, where reprint requests should be addressed to Dr. Spitz.
References
This article has been cited by other articles:
Cassier, P. A, Abou-Amara-Olivieri, S., Artru, P., Lapalus, M.-G., Riou, J.-P., Lombard-Bohas, C.
(2008). Mifepristone for ectopic ACTH secretion in metastatic endocrine carcinomas: report of two cases.. Eur J Endocrinol
158: 935-938
[Abstract][Full Text]
Johanssen, S., Allolio, B.
(2007). Mifepristone (RU 486) in Cushing's syndrome. Eur J Endocrinol
157: 561-569
[Abstract][Full Text]
Breen, K. M., Oakley, A. E., Pytiak, A. V., Tilbrook, A. J., Wagenmaker, E. R., Karsch, F. J.
(2007). Does Cortisol Acting Via the Type II Glucocorticoid Receptor Mediate Suppression of Pulsatile Luteinizing Hormone Secretion in Response to Psychosocial Stress?. Endocrinology
148: 1882-1890
[Abstract][Full Text]
Lewis-Tuffin, L. J., Jewell, C. M., Bienstock, R. J., Collins, J. B., Cidlowski, J. A.
(2007). Human Glucocorticoid Receptor {beta} Binds RU-486 and Is Transcriptionally Active. Mol. Cell. Biol.
27: 2266-2282
[Abstract][Full Text]
Zhang, J., Tsai, F. T F, Geller, D. S
(2006). Differential interaction of RU486 with the progesterone and glucocorticoid receptors.. J Mol Endocrinol
37: 163-173
[Abstract][Full Text]
Breen, K. M., Stackpole, C. A., Clarke, I. J., Pytiak, A. V., Tilbrook, A. J., Wagenmaker, E. R., Young, E. A., Karsch, F. J.
(2004). Does the Type II Glucocorticoid Receptor Mediate Cortisol-Induced Suppression in Pituitary Responsiveness to Gonadotropin-Releasing Hormone?. Endocrinology
145: 2739-2746
[Abstract][Full Text]
Song, L.-N., Coghlan, M., Gelmann, E. P.
(2004). Antiandrogen Effects of Mifepristone on Coactivator and Corepressor Interactions with the Androgen Receptor. Mol. Endocrinol.
18: 70-85
[Abstract][Full Text]
Woodland, C., Koren, G., Ito, S.
(2003). From Bench to Bedside: Utilization of an In Vitro Model to Predict Potential Drug-Drug Interactions in the Kidney: The Digoxin-Mifepristone Example. J Clin Pharmacol
43: 743-750
[Abstract][Full Text]
Raivio, T., Palvimo, J. J., Kannisto, S., Voutilainen, R., Janne, O. A.
(2002). Transactivation Assay for Determination of Glucocorticoid Bioactivity in Human Serum. J. Clin. Endocrinol. Metab.
87: 3740-3744
[Abstract][Full Text]
Sathya, G., Jansen, M. S., Nagel, S. C., Cook, C. E., MCDonnell, D. P.
(2002). Identification and Characterization of Novel Estrogen Receptor-{beta}-Sparing Antiprogestins. Endocrinology
143: 3071-3082
[Abstract][Full Text]
Pomara, N., Doraiswamy, P. M., Tun, H., Ferris, S.
(2002). Mifepristone (RU 486) for Alzheimer's disease. Neurology
58: 1436-1436
[Full Text]
Chu, J. W., Matthias, D. F., Belanoff, J., Schatzberg, A., Hoffman, A. R., Feldman, D.
(2001). Successful Long-Term Treatment of Refractory Cushing's Disease with High-Dose Mifepristone (RU 486). J. Clin. Endocrinol. Metab.
86: 3568-3573
[Abstract][Full Text]
Giannoukos, G., Szapary, D., Smith, C. L., Meeker, J. E. W., Simons, S. S. Jr.
(2001). New Antiprogestins with Partial Agonist Activity: Potential Selective Progesterone Receptor Modulators (SPRMs) and Probes for Receptor- and Coregulator-Induced Changes in Progesterone Receptor Induction Properties. Mol. Endocrinol.
15: 255-270
[Abstract][Full Text]
Weiss, G.
(2000). Endocrinology of Parturition. J. Clin. Endocrinol. Metab.
85: 4421-4425
[Full Text]
Christin-Maitre, S., Bouchard, P., Spitz, I. M.
(2000). Medical Termination of Pregnancy. NEJM
342: 946-956
[Full Text]
Newfield, R. S., Kalaitzoglou, G., Licholai, T., Chilton, D., Ashraf, J., Thompson, E. B., New, M. I.
(2000). Normocortisolemic Cushing's Syndrome Initially Presenting with Increased Glucocorticoid Receptor Numbers. J. Clin. Endocrinol. Metab.
85: 14-21
[Abstract][Full Text]
Baird, D. T
(2000). Clinical Uses of Antiprogestogens. Reproductive Sciences
7: S49-S52
[Abstract]
He, K., Woolf, T. F., Hollenberg, P. F.
(1999). Mechanism-Based Inactivation of Cytochrome P-450-3A4 by Mifepristone (RU486). J. Pharmacol. Exp. Ther.
288: 791-797
[Abstract][Full Text]
Schneider, C. C., Gibb, R. K., Taylor, D. D., Wan, T., Gercel-Taylor, C.
(1998). Inhibition of Endometrial Cancer Cell Lines by Mifepristone (RU 486). Reproductive Sciences
5: 334-338
[Abstract]
Lockwood, C. J., Krikun, G., Hausknecht, V. A., Papp, C., Schatz, F.
(1998). Matrix Metalloproteinase and Matrix Metalloproteinase Inhibitor Expression in Endometrial Stromal Cells during Progestin-Initiated Decidualization and Menstruation-Related Progestin Withdrawal. Endocrinology
139: 4607-4613
[Abstract][Full Text]
Goldberg, J. R., Plescia, M. G., Anastasio, G. D.
(1998). Mifepristone (RU 486): Current Knowledge and Future Prospects. Arch Fam Med
7: 219-222
[Abstract][Full Text]
Spitz, I. M., Bardin, C. W., Benton, L., Robbins, A.
(1998). Early Pregnancy Termination with Mifepristone and Misoprostol in the United States. NEJM
338: 1241-1247
[Abstract][Full Text]
Vicent, G. P., Monteserín, M. C., Veleiro, A. S., Burton, G., Lantos, C. P., Galigniana, M. D.
(1997). 21-Hydroxy-6,19-oxidoprogesterone: A Novel Synthetic Steroid with Specific Antiglucocorticoid Properties in the Rat. Mol. Pharmacol.
52: 749-753
[Abstract][Full Text]
Schatz, F., Papp, C., Aigner, S., Krikun, G., Hausknecht, V., Lockwood, C. J.
(1997). Biological Mechanisms Underlying the Clinical Effects of RU 486: Modulation of Cultured Endometrial Stromal Cell Stromelysin-1 and Prolactin Expression. J. Clin. Endocrinol. Metab.
82: 188-193
[Abstract][Full Text]