Ulipristal acetate an effective alternative for emergency contraception

January 01, 0001

Ulipristal acetate an effective alternative for emergency contraception

Emergency contraception can prevent unintended pregnancies, but current methods are only effective if used as soon as possible after sexual intercourse and before ovulation. The researchers from the UK, USA and France compared the efficacy and safety of ulipristal acetate with levonorgestrel for emergency contraception. Women with regular menstrual cycles who presented to a participating family planning clinic requesting emergency contraception within 5 days of unprotected sexual intercourse were eligible for enrolment in this randomised, multicentre, non-inferiority trial. 2221 women were randomly assigned to receive a single, supervised dose of 30 mg ulipristal acetate (n=1104) or 1·5 mg levonorgestrel (n=1117) orally. Participants were masked to treatment assignment whereas investigators were not. Follow-up was done 5—7 days after expected onset of next menses. In the efficacy-evaluable population, 1696 women received emergency contraception within 72 h of sexual intercourse (ulipristal acetate, n=844; levonorgestrel, n=852).

There were 15 pregnancies in the ulipristal acetate group (1·8%) and 22 in the levonorgestrel group (2·6%; OR 0·68). In 203 women who received emergency contraception between 72 h and 120 h after sexual intercourse, there were three pregnancies, all of which were in the levonorgestrel group. The most frequent adverse event was headache (ulipristal acetate 19·3%, levonorgestrel 18·9%). Two serious adverse events were judged possibly related to use of emergency contraception; a case of dizziness in the ulipristal acetate group and a molar pregnancy in the levonorgestrel group. In the meta-analysis (0—72 h), there were 1·4% pregnancies in 1617 women in the ulipristal acetate group and 2·2% in 1625 women in the levonorgestrel group (OR 0·58, significant).

The researchers concluded: "Ulipristal acetate provides women and health-care providers with an effective alternative for emergency contraception that can be used up to 5 days after unprotected sexual intercourse."

The word "emergency" is becoming less appropriate (just as ‘morning after’ went the same way).

For the full abstract, click here.

The Lancet published online 29 January 2010
© 2010 Elsevier Ltd
Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis. Prof Anna F Glasier, Sharon T Cameron, Paul M Fine et al. Correspondence to Anna Glasier: [email protected]

Category: W. Pregnancy/Childbirth/Family Planning. Keywords: ulipristal acetate, levonorgestrol, emergency, contraception, randomised multicentre non inferiority trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 25 February 2010

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