META-ANALYSIS OF USE OF 200 OR 600 MG OF MIFEPRISTONE IN COMBINATION WITH TWO TYPES OF PROSTAGLANDINS FOR THE EARLY INTERRUPTION OF PREGNANCY (ORIGINAL SCIENTIFIC ARTICLE) *, #


Michelle Levre (1), Regine Sitruk - Ware (2)

(1) Department of Pharmacology, University of Lyon 1, France; (2) Population Council and Rockefeller University, New York, USA
There are different opinions regarding the efficacy and safety of use of mifepristone at a dose of 200 mg and 600 mg in combination with two types of prostaglandins for interruption of pregnancy up to 63 days. We have performed the meta-analysis of randomized controlled trials (RCTs) directly comparing the two dosing schedules. Study outcome measures included complete abortion, maintaining the pregnancy, and side effects. Four RCTs (3482 patients) were identified. The same efficacy of mifepristone at a dose of 200 mg compared with 600 mg was proved in respect of complete abortion (difference - 0.4 %, 95% confidence interval [CI] from -1.4 to 2.3 %). The same efficacy in terms of maintaining the pregnancy (difference - 0.4 %, 95% CI from 0.3 to 1.0 %) has not been proven. This means that the proportion of maintaining pregnancies at a dose of 200 mg of mifepristone can be 1% higher than at a dose of 600 mg in the case of the combination with the authorized schemes of use of prostaglandins. Sensitivity analyzes have confirmed these findings. Significant difference in side effects between the two doses of mifepristone was not revealed. Thus, despite the fact that a doses of 200 or 600 mg of mifepristone in combination with two prostaglandins seems to be same effective in terms of complete abortion, replacement 600 with 200 mg can increase the percentage of maintaining pregnancies.

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