MIFEPRISTONE (RU-486) - PRESENT AND FUTUR E

Mifepristone (RU 486) has many therapeutic possibilities, which largel y exceed simple interruption of pregnancy. They are due to its unique properties of progesterone - and glucocorticosteroid - receptor blocka ge. In early interruption of pregnancy, the association with a prostag landin analogue represents an efficient and well-tolerated method. The safety and comfort of the method have been improved by the associatio n with misoprostol, an oral prostaglandin analogue. Mifepristone can a lso be used in late pregnancy interruptions for medical reasons, as we ll as for expulsion of an in utero dead fetus. In these indications, i ts use allows to decrease or even to avoid the use of prostaglandins, thus diminishing the side-effects due to these products. Several other gynaecological and obstetrical indications seem promising in the futu re : dilatation and ripening of uterine cenix, induction of labour for medical reasons, contraception. Trials are ongoing to evaluate the an titumoural activity of mifepristone in meningiomas and breast cancer. Finally, its anti-glucocorticosteroid effect is used in the treatment of Cushing's syndromes due to ectopic secretion of ACTH and other indi cations may be foreseen.