Friday, September 29, 2000
Drug has potential to help women with other ailments
By Peggy O'Farrell
The Cincinnati Enquirer
The approval of RU-486 for abortions gives women more options, and not just for terminating pregnancies.
Dr. Michael A. Thomas, director of the University of Cincinnati's Center for Reproductive Health, said the debate over the drug centers on its use to terminate pregnancy as an alternative to surgical abortion.
But there are other uses, experts say. RU-486 has also been used in Europe for several years as emergency contraception or a “morning-after pill."
And, paradoxically, it and variations of it could be used to treat women who suffer from fibroid tumors and endometriosis — two conditions that prevent many women from becoming pregnant.
RU-486, also known as mifepristone, has also been used in Europe to treat adrenal tumors, said Dr. Robert Rebar, associate executive director of the American Society of Reproductive Medicine and former chairman of ob stetrics/gynecology at the University of Cincinnati. But the debate over its use to terminate pregnancy has limited both the amount of research and the potential for manufacture in the United States, he said.
Antiprogestins like RU-486 could potentially have “a wealth of uses,” Dr. Rebar said.
The drug has “many uses with very few side effects. For that reason, I think it's a welcome addition to the women's health arena,” Dr. Thomas said.
A new generation of antiprogestins is being studied for its effectiveness treating endometriosis and fibroids, Dr. Thomas said. Mifepristone and its descendants will be an important addition in treating both of those conditions and could mean improved fertility and fewer hysterectomies for many women.
Abortion opponents are decrying the FDA's decision, but Dr. Thomas pointed out that even before abortion was legalized in this country in 1973, some doctors privately performed surgical abortions in their clinics. And the availability of RU-486 means that doctors who are uncomfortable with performing surgical abortions might be willing to prescribe the drug as a medical alternative.
“We would like to live in a world where patients don't have unintended pregnancies,” Dr. Thomas said. “This is a way to hopefully decrease the number of surgical abortions.”
Susan Momoyer, CEO of Planned Parenthood of Southwest Ohio and Northern Kentucky, said the FDA's decision and the conditions placed on how the drug can be prescribed “seem appropriate,” and added that the drug has been used for more than a decade in Europe as a safe and effective option for women.
Both she and Dr. Thomas pointed out that using RU-486 does require medical supervision and follow-up. A woman has to take the medication at the doctor's office after pregnancy testing and a physical exam, then return for follow-up visits and administration of a second drug, misoprostol, to complete the pregnancy termination.
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