In June, the Supreme Court upheld the FDA’s approval of mifepristone, which was originally approved in 2000 along with misoprostol to terminate pregnancies. Since then, Louisiana has classified mifepristone as a controlled substance, creating additional access barriers. And three other states have filed lawsuits against the FDA, alleging the drug’s approval is a public health risk.
Researchers have noted that mifepristone is relatively expensive and inaccessible in many countries.
However, ulipristal acetate — a drug approved for birth control and uterine fibroids medication — has shown potential for terminating pregnancies in the second trimester with a dose of 60 to 90 milligrams, according to a study published Jan. 23 in NEJM Evidence. The birth control drug is currently approved at a 30-milligram dose.
The study evaluated a regimen of ulipristal and misoprostol for inducing abortions within 63 days of gestation. Sixty-six participants were divided into two groups: half received 60 milligrams of oral ulipristal followed by 800 micrograms of buccal misoprostol, while the other half received 90 milligrams of ulipristal with the same dose of misoprostol.
No serious adverse events occurred in either cohort. The 60-milligram regimen demonstrated 97% efficacy, while the 90-milligram regimen was 100% effective.
Gynuity Health Projects and the National Autonomous University of Mexico designed the study. Participants had intrauterine pregnancies of fewer than 64 days confirmed by ultrasound, a body mass index of 32 or lower, and were residents of Mexico City.
Access the study here.
