{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:34:26Z","timestamp":1777948466165,"version":"3.51.4"},"reference-count":15,"publisher":"Rambam Health Corporation","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rambam Maimonides Med J"],"abstract":"<jats:p>Mifepristone (RU-486), the first clinically effective progesterone antagonist, was initially identified as having antiglucocorticoid activity. Although early interest focused on its role as a glucocorticoid receptor antagonist, recognition of its antiprogesterone effects led to studies of its role in pregnancy termination. This article reviews the steps leading to its use as an abortifacient, from its initial identification for this indication and draws on the author\u2019s direct involvement in the field with reflections on his contribution to the early clinical development of mifepristone. These studies established the efficacy of mifepristone in pregnancy termination. Unfortunately, its wider therapeutic applications have received limited attention.<\/jats:p>","DOI":"10.5041\/rmmj.10576","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T07:24:44Z","timestamp":1777188284000},"page":"e0016","source":"Crossref","is-referenced-by-count":0,"title":["Mifepristone: Reflections on its Early Clinical Development for Medical Abortion"],"prefix":"10.5041","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6804-1131","authenticated-orcid":false,"given":"Irving","family":"Spitz","sequence":"first","affiliation":[{"name":"Adjunct Professor of Medicine, Joan and Sanford I. Weill Medical College of Cornell University, New York City, NY, USA; Emeritus Professor of Endocrinology, Ben Gurion University of the Negev, BeerSheva, Israel; and Institute of Hormone Research, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2983","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/0039-128X(81)90084-2","article-title":"17 alpha-alkynyl-11 beta, 17-dihydroxyandrostane derivatives: a new class of potent glucocorticoids","volume":"38","author":"Teutsch","year":"1981","unstructured":"1. Teutsch G, Costerousse G, Deraedt R, Benzoni J, Fortin M, Philibert D. 17 alpha-alkynyl-11 beta, 17-dihydroxyandrostane derivatives: a new class of potent glucocorticoids. Steroids 1981;38:651-65.","journal-title":"Steroids"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. Philibert D, Deraedt R, Tournemine C, Mary I, Teutsch G. 204. RU 38486 - A potent antiprogesterone. Sixth International Congress on Hormonal Steroids, Jerusalem, Israel; September 5-10, 1982. 17. New Steroids: Synthesis and structure-activity relationship I. J Steroid Biochem 1982;27:lxviii.","DOI":"10.1016\/0022-4731(82)90418-6"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1056\/NEJM199308053290607","article-title":"Mifepristone (RU 486)--a modulator of progestin and glucocorticoid action","volume":"329","author":"IM","year":"1993","unstructured":"3. Spitz IM, Bardin CW. Mifepristone (RU 486)--a modulator of progestin and glucocorticoid action. N Engl J Med 1993;329:404-12.","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/0010-7824(85)90115-5","article-title":"Effect on uterine contractility and early pregnancy","volume":"32","author":"Bygdeman","year":"1985","unstructured":"4. Bygdeman M, Swahn ML. Progesterone receptor blockage. Effect on uterine contractility and early pregnancy. Contraception 1985;32:45-51.","journal-title":"Contraception"},{"key":"ref4","unstructured":"5. Joffe C, Weitz TA, Stacey CL. An epidemic of antiabortion violence in the United States. Am J Public Health 1990;80:795-8."},{"key":"ref5","unstructured":"6. American Civil Liberties Union. ACLU's Role in Stopping Clinic Violence. New York (NY): American Civil Liberties Union; 2005. Available at: https:\/\/www.aclu.org\/documents\/aclus-role-stopping-clinic-violence (accessed March 24, 2026)."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1056\/NEJM199804303381801","article-title":"Early pregnancy termination with mifepristone and misoprostol in the United States","volume":"338","author":"Spitz","year":"1998","unstructured":"7. Spitz IM, Bardin CW, Benton L, Robbins A. Early pregnancy termination with mifepristone and misoprostol in the United States. N Engl J Med 1998; 338:1241-7.","journal-title":"N Engl J Med"},{"key":"ref7","unstructured":"8. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Board on Population Health and Public Health Practice; Committee on Reproductive Health Services. Assessing the Safety and Quality of Abortion Care in the U.S. 4, Long-Term Health Effects. In: The Safety and Quality of Abortion Care in the United States. Washington, DC: National Academies Press (US); 2018 Mar 16. Available at: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK507237\/ (accessed March 24, 2026)."},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Gynecology, Society of Family Planning. Medication Abortion Up to 70 Days of Gestation: ACOG Practice Bulletin, Number 225. Obstet Gynecol 2020;136:e31-47.","DOI":"10.1097\/AOG.0000000000004082"},{"key":"ref9","unstructured":"10. American College of Obstetricians and Gynecologists. Updated Mifepristone REMS Requirements. Practice Advisory. Washington, DC: ACOG; 2023 Jan 3. Available at: https:\/\/www.acog.org\/clinical\/clinical-guidance\/practice-advisory\/articles\/2023\/01\/updated-mifepristone-rems-requirements (accessed March 24, 2026)."},{"key":"ref10","unstructured":"11. Guttmacher Institute. Mifepristone for Abortion in a Global Context: Safe, Effective and Approved in Nearly 100 Countries. New York, NY: Guttmacher Institute; 2023 Jul 18. Available at: https:\/\/www.guttmacher.org\/2023\/07\/mifepristone-abortion-global-context-safe-effective-and-approved-nearly-100-countries (accessed March 24, 2026)."},{"key":"ref11","unstructured":"12. Guttmacher Institute. Medication Abortions Accounted for 63% of All US Abortions in 2023, an Increase from 53% in 2020. New York, NY: Guttmacher Institute; 2024 Mar 11. Available at: https:\/\/www.guttmacher.org\/news-release\/2024\/medication-abortions-accounted-63-all-us-abortions-2023-increase-53-2020 (accessed March 24, 2026)."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1056\/NEJMoa070445","article-title":"Medical abortion and the risk of subsequent adverse pregnancy outcomes","volume":"357","author":"Virk","year":"2007","unstructured":"13. Virk J, Zhang J, Olsen J. Medical abortion and the risk of subsequent adverse pregnancy outcomes. New Engl J Med 2007;357:648-53.","journal-title":"New Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2965","DOI":"10.1210\/en.2012-1078","article-title":"The Endocrine Society 2013 Laureate Awards","volume":"154","author":"14","year":"2013","unstructured":"14. The Endocrine Society 2013 Laureate Awards. Endocrinology 2013;154:2965-80.","journal-title":"Endocrinology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/j.contraception.2009.12.012","article-title":"Mifepristone: where do we come from and where are we going? Clinical development over a quarter of a century","volume":"82","author":"Spitz","year":"2010","unstructured":"15. Spitz IM. Mifepristone: where do we come from and where are we going? Clinical development over a quarter of a century. Contraception 2010;82:442-52.","journal-title":"Contraception"}],"container-title":["Rambam Maimonides Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.rmmj.org.il\/userimages\/4590\/1\/PublishFiles\/4702Article.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T08:58:17Z","timestamp":1777798697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.rmmj.org.il\/issues\/71\/articles\/4702"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,26]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,26]]}},"URL":"https:\/\/doi.org\/10.5041\/rmmj.10576","relation":{},"ISSN":["2076-9172"],"issn-type":[{"value":"2076-9172","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,26]]}}}