Treatment of endometriosis with the antiprogesterone mifepristone (RU486)
OBJECTIVE
To evaluate the safety and efficacy of an antiprogesterone (mifepristone, RU486; Roussel-Uclaf, Romaineville, France) on endometriosis.


METHODS
An open, prospective clinical trial.


METHODS
The clinical practice of an academic faculty.


METHODS
Nine women with endometriosis were studied.


METHODS
RU486 (50 mg/d) was administered for 6 months.


METHODS
Daily symptom inventories and urinary steroid metabolites were assessed before, during, and after treatment. Blood for hormone analysis was obtained weekly for 4 weeks and monthly thereafter. The extent of endometriosis, bone mineral density, circadian rhythm of cortisol, and LH pulsatility were determined before and after treatment. Safety laboratory measurements were made before and at 1, 2, and 6 months of treatment.


RESULTS
Pelvic pain and uterine cramping improved in all patients. Endometriosis regressed by 55%. All patients exhibited endocrine features of anovulatory amenorrhea without hypoestrogenism. A rise in serum LH and T levels was observed during the first month of treatment and one patient developed an elevation of liver transaminases during the last month of treatment. All other measurements were unchanged.


CONCLUSIONS
RU486 appears to be effective in improving the symptoms and causing regression of endometriosis in the absence of significant side effects.
Kettel
L M
LM
University of California-San Diego, La Jolla, USA.
Murphy
A A
AA
Morales
A J
AJ
Ulmann
A
A
Baulieu
E E
EE
Yen
S S
SS
D000293:Adolescent; D000328:Adult; D004715:Endometriosis / Q000188:drug therapy*; D004970:Estrone / Q000031:analogs & derivatives / Q000652:urine; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D015735:Mifepristone / Q000009:adverse effects / Q000627:therapeutic use*; D011374:Progesterone / Q000037:antagonists & inhibitors*; D011446:Prospective Studies
D006727:Hormone Antagonists; C015856:estrone-3-glucuronide; D004970:Estrone; D015735:Mifepristone; D011374:Progesterone; D007986:Luteinizing Hormone