title: Management of patients receiving long-term treatment with mifepristone.
abstract: OBJECTIVE
  To determine clinical side effects and biochemical and hematological abnormalities in patients with nonresectable meningioma on long-term mifepristone (RU 486) therapy.
  
  
  METHODS
  Long-term mifepristone administration in patients with meningioma.
  
  
  METHODS
  Outpatient clinic of a university hospital.
  
  
  METHODS
  Sixteen women and 9 men aged 22-80 years with nonresectable meningioma.
  
  
  METHODS
  Mifepristone (200 mg daily). One patient received treatment for more than 13 years; six received treatment for 10-12 years; five received treatment for 4-9 years; eight received treatment for 1-4 years; and the remainder received treatment for 4-10 months.
  
  
  METHODS
  Evaluation of side effects and of hematological and biochemical abnormalities.
  
  
  RESULTS
  Fatigue was observed in 22 of 25 patients. Endometrial hyperplasia occurred in one premenopausal woman and one postmenopausal woman. Another two women had endometrial thickening without hyperplasia. There were no consistent abnormalities in liver or renal function or in any other biochemical or hematological parameters. One subject (on long-term dexamethasone) developed hypoadrenalism, which responded to treatment.
  
  
  CONCLUSIONS
  Mifepristone can be administered for prolonged periods. Ultrasound should be performed if irregular vaginal bleeding occurs. In asymptomatic women, it should be performed annually. If endometrial thickening is observed, then endometrial biopsy is recommended. Because biochemical hypothyroidism has been reported during long-term mifepristone therapy, thyroid function tests should be performed annually.
authors.affiliation: Institute of Hormone Research, Jerusalem, Israel. irving@spitz.com
authors.forename: Irving M
authors.initials: IM
authors.lastname: Spitz
authors.forename: Steven M
authors.initials: SM
authors.lastname: Grunberg
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chabbert-Buffet
authors.forename: Tzina
authors.initials: T
authors.lastname: Lindenberg
authors.forename: Hadassa
authors.initials: H
authors.lastname: Gelber
authors.forename: Regine
authors.initials: R
authors.lastname: Sitruk-Ware
mesh_terms: D000309:Adrenal Insufficiency / Q000139:chemically induced / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000568:Amenorrhea / Q000139:chemically induced / Q000473:pathology; D016903:Drug Monitoring / Q000379:methods; D004714:Endometrial Hyperplasia / Q000139:chemically induced / Q000473:pathology; D005260:Female; D006727:Hormone Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000188:drug therapy*; D008579:Meningioma / Q000188:drug therapy*; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors
chemical_list: D006727:Hormone Antagonists; D015735:Mifepristone