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Clinical Applications of Mifepristone (RU486) and Other Antiprogestins: Assessing the Science and Recommending a Research Agenda (1993)
Institute of Medicine (IOM)

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. "B1. 1993: RU 486--A Decade on Today and Tomorrow." Clinical Applications of Mifepristone (RU486) and Other Antiprogestins: Assessing the Science and Recommending a Research Agenda. Washington, DC: The National Academies Press, 1993.

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Clinical Applications of Mifepristone (RU 486) and other Antiprogestins: Assessing the Science and Recommending a Research Agenda
Use for Voluntary Pregnancy Interruption

The RU 486-plus-misoprostol combined method is ready to be used at large. It works, is safe, and is close to being as convenient as a medical method of abortion may be. Given the global demographic issue, the suffering of women, and related health problems, it must soon be made available in the United States—a key to further worldwide development. Studies must rapidly discern the best conditions for its distribution in parts of the world where there are obstacles, including developing countries. The early use of RU 486, as soon as a woman fears a pregnancy that she does not want, will help to defuse the abortion issue.

Contraception

Research should be conducted to define convenient and safe contraceptive methods with RU 486 or other antiprogestins. There are serious hopes, and it is now a matter of conducting systematic studies. However, it will take several years and a great deal of money. Significant success also will contribute to decreasing the practice of abortion as we know it.

Cancer

Nonreproductive medicine should investigate the regulatory properties of RU 486 and its derivatives in several diseases. The most cruel, breast cancer, should be first on the list of trials. Again, this may take time and money, but there already are clues that cannot be neglected.

Novel Antiprogestins: Biology and Chemistry

There is enough data to suggest that RU 486 is only the first in a series of new compounds with significant differences that could be medically exploitable (Table B1.7). Therefore, basic, novel, interactive chemical and biological research should be continued forcefully.

ACKNOWLEDGMENTS

I would like to acknowledge the editorial work of Rod Fiddes, Ph.D., and contributions to the manuscript by Françoise Boussac, Jean-Claude Lambert, Philippe Leclerc, Corinne Legris, Luc Outin, and Claude Secco. This work could not have been presented without the long-time collaboration of my INSERM colleagues and of the researchers at Roussel-Uclaf (Romainville, France).

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