UCSF researchers to test methotrexate in pill form as abortion agent

Business Wire, March 13, 1996

SAN FRANCISCO--(BUSINESS WIRE)--March 13, 1996--UC San Francisco researchers have begun a clinical trial to determine if the drug methotrexate can be used effectively as an abortion agent when taken in pill form.

In a previous study, 300 women who were less than eight weeks pregnant received the drug via injection, followed by the hormone misoprostol a week later, said Philip Darney, MD, UCSF professor of obstetrics, gynecology and reproductive sciences at the UCSF-affiliated San Francisco General Hospital and principal investigator in the studies.

"We found it was safe. There have been no adverse effects. It was more than 90 percent effective. The earlier it is used in the pregnancy, the more effective it is," Darney said.

Darney said that giving women methotrexate in pill form would simplify the process and minimize the number of clinic visits required of patients. If this method proves effective, it might make it possible for women to obtain a doctor's prescription for the drug, which they could take in the privacy of their homes, he said.

"I think medical abortion will be an advantage for women," Darney said. "I don't think it will increase abortion in the United States. Abortion rates have been declining as we do a better job of providing contraception.

"I do think medical abortion will encourage women to have an abortion earlier, which is a good thing," he said. "And it will make abortion available in places where it is not now available. Women and providers who support safe medical abortion would not be as subject to harassment -- and even violence."

Methotrexate is best known as an anti-cancer drug and is approved in this country for treatment of rheumatoid arthritis and the skin disorder psoriasis.

The drug will be tested in a total of 300 women at four sites, including 75 women seeking abortions at San Francisco General Hospital. The other sites are the University of Pittsburgh, the University of Rochester and Reproductive Health Services, a private clinic in St. Louis.

To be eligible for the study, the women must be less than seven weeks pregnant. After an initial screening, they will receive 50 milligrams of methotrexate, or four pills, to take in the clinic office. They also will be given four misoprostol pills that they will be instructed to insert in the vagina a week later. Misoprostol induces uterine contractions, which lead to expulsion of the pregnancy, usually within 24 hours, Darney said. The women will be asked to return to the clinic for a follow-up visit.

Darney said most women experience some cramping after taking misoprostol and a small number experience nausea, vomiting, diarrhea, headache, dizziness and hot flashes from the treatment. Women seeking more information on the trial can call 415/502-0299.

CONTACT: UCSF

Ruthann Richter, 415/476-3804