Management of patients receiving long-term treatment with mifepristone.
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.
Spitz
Irving M
IM
Institute of Hormone Research, Jerusalem, Israel. irving@spitz.com
Grunberg
Steven M
SM
Chabbert-Buffet
Nathalie
N
Lindenberg
Tzina
T
Gelber
Hadassa
H
Sitruk-Ware
Regine
R
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
D006727:Hormone Antagonists; D015735:Mifepristone