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Medical AbortionPhase 4NCT02745093

Medical Abortion at Gestational Age of 8 to ≤9 Weeks Versus >9 to ≤12 Weeks

A Phase 4 study testing Mifepristone and Misoprostol in people with Medical Abortion, run by Ibis Reproductive Health at 3 sites in Mexico.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to assess the effectiveness, safety, and acceptability of home-administered medical abortion at gestational age of 8 to ≤9 weeks versus >9 to ≤12 weeks among a cohort of women in Mexico City. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Medical Abortion
What is being tested?
Mifepristone and Misoprostol
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
648 participants
Where
3 sitesMexico
Study dates
Sep 2016to Dec 2016
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 18 or older
  • Intrauterine pregnancy 57- 84 days, assessed using clinical assessment and transvaginal or transabdominal ultrasound by crown-rump length (machines will be calibrated and will use a standardized conversion formula to determine gestational age)
  • Eligible for medical abortion according to doctor assessment
  • Elected medical abortion over surgical abortion after comprehensive counselling
  • Haemoglobin level ≥10 g/dl measured by Hemocue
  • Willing and able to sign consent forms
Show all 11Show fewer
  • Able to speak and read Spanish
  • Agree to comply with the study procedures and visit schedule
  • Access to own telephone and to emergency transportation
  • Access to a toilet with privacy
  • Reside no more than 30 minutes car journey from the Sta. Mónica Hospital in Polanco or the Marie Stopes Mexico Roma Clinic

Who cannot join

  • History or evidence of disorders that represent a contraindication to the use of mifepristone or misoprostol (chronic adrenal failure, severe asthma uncontrolled by corticosteroid therapy, inherited porphyries, glaucoma, mitral stenosis, hepatic or renal disease)
  • History of bleeding disorder or current anticoagulant therapy
  • Previous allergic reaction to any drugs in the regimen
  • Suspicion of any pathology of pregnancy (e.g. molar, ectopic, non-viable pregnancy)
  • Multiple gestation
  • Presence of an intrauterine device

Trial locations and contacts

3 sites in 1 country.

Mexico3 sites
  • Marie Stopes Mexico Azcapotzalco

    Del. Azcapotzalco, Mexico Distrito Federal, 02000

  • Marie Stopes Mexico Roma

    Del. Cuauhtémoc, Mexico Distrito Federal, 06760

  • Marie Stopes Mexico Pedregal

    Del. Tlalpan, Mexico Distrito Federal, 14010

Other trials in Mexico

About this study

Official title: The Effectiveness, Safety, and Acceptability of Home-administered Medical Abortion at Gestational Age of 8 to ≤9 Weeks Versus >9 to ≤12 Weeks: A Prospective Cohort Study in Mexico City

The purpose of this study is to assess the effectiveness, safety, and acceptability of home-administered medical abortion at gestational age of 8 to ≤9 weeks versus >9 to ≤12 weeks among a cohort of women in Mexico City.

Read the detailed description

Medical abortion represents an important alternative to surgical methods for termination of early pregnancy. In Mexico City, abortion is legal on request up to 12 weeks of gestation; however, medical abortion is currently only offered up to 10 weeks at Marie Stopes Mexico clinics. The World Health Organization guidelines state that medical abortion drugs may be used to terminate pregnancy up to a gestational age of 24 weeks in clinical settings, with recommended regimens differing by gestational age. However, data are lacking on the safety and effectiveness of home-based medical abortion regimens for pregnancy terminations between >9 and ≤12 weeks' gestation. Investigators propose a prospective cohort study with women between 8 and ≤9 weeks and >9 and ≤12 weeks of pregnancy at Marie Stopes Mexico clinics to compare the effectiveness, safety, and acceptability of mifepristone followed by home-based misoprostol use in these two gestational age groups. The information from this study will inform policy and practice guidelines in Mexico City and potentially other locations by providing evidence on the safety, effectiveness, and acceptability of home-use of medical abortion between >9 and ≤12 weeks of gestation.

Being tested
Mifepristone, Misoprostol
Keywords
Abortion induced, Patient Acceptance of Healthcare, safety, effectiveness, misoprostol, mifepristone
Medical subject headings
Patient Acceptance of Health Care

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MifepristoneDrug

    Women at 64-84 days' gestation will use the following dosing regimen: 200 µg mifepristone administered orally in the clinic on Day 1.

  • MisoprostolDrug

    The client will then be given a total of 2400 µg misoprostol tablets to take home, and will be instructed to take 800 μg misoprostol administered sublingually 24-48 hours later at home and to administer a subsequent dose of 400 μg misoprostol sublingually every 3 hours up to a total of four further doses or until expulsion of the products of conception, whichever comes first.

Study groups in NCT02745093
Study groupRoleWhat they receive
64-84 days gestational ageExperimentalWomen whose pregnancies are estimated to have a gestational age of 64-84 days will receive 200 µg mifepristone followed by misoprostol 24-48 hours later.
Receives: Drug: Mifepristone; Drug: Misoprostol
57-63 days gestational ageNo interventionWomen whose pregnancies are estimated to have a gestational age of 57-63 days. (Women in this arm receive the standard of care for medical termination of pregnancy in the stated gestational age range: 200 µg mifepristone administered orally in the clinic on Day 1 then 800 μg misoprostol administered sublingually 24-48 hours later at home with a subsequent dose of 400 μg misoprostol sublingually 6 hours later if she has not expelled the pregnancy).

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of participants with complete abortion without surgical intervention by day 30 from mifepristone administration, regardless of misoprostol dosing, by gestational age group

    Measured: 2-4 weeks

Secondary outcomes (22)
  1. Experience of any major adverse event overall, and by type (emergency room treatment, hospitalization, transfusion, unrecognized ectopic pregnancy, allergic reaction, infection requiring intravenous treatment, and death), by gestational age group

    Measured: 2-4 weeks

  2. Proportion of participants by gestational age group with complete abortion without surgical intervention after 1, 2, 3, 4, and 5 doses of misoprostol, by gestational age group

    Measured: 2-4 weeks

  3. Number of participants requiring surgical intervention to complete an abortion due to an ongoing pregnancy, by gestational age group

    Measured: 2-4 weeks

  4. Number of participants requiring surgical intervention to complete an abortion due to the presence of a persistent non-viable sac, by gestational age group

    Measured: 2-4 weeks

  5. Number of participants requiring surgical intervention to complete an abortion due to substantial debris in uterus, by gestational age group

    Measured: 2-4 weeks

  6. Number of participants requiring surgical intervention to complete an abortion due to excessive prolonged bleeding indicated as severe on the adverse event form, by gestational age group

    Measured: 2-4 weeks

  7. Number of participants requiring surgical intervention to complete an abortion due to woman's request, by gestational age group

    Measured: 2-4 weeks

  8. Number of participants requiring an unscheduled clinic visit, by gestational age group

    Measured: 2-4 weeks

  9. Number of participants who called the helpline, by gestational age group

    Measured: 2-4 weeks

  10. Time to expulsion in days, by gestational age group

    Measured: 2-4 weeks

  11. Side effects overall and by type (chills, fever, vomiting, nausea, diarrhoea, and severe pain), by gestational age group

    Measured: 2-4 weeks

  12. Duration of heavy bleeding, by gestational age group

    Measured: 2-4 weeks

  13. Duration of work or school missed, by gestational age group

    Measured: 2-4 weeks

  14. Pain reliever use

    Measured: 2-4 weeks

  15. Satisfied or very satisfied with abortion method, by gestational age group

    Measured: 2-4 weeks

  16. Would choose medical abortion again instead of surgical, by gestational age group

    Measured: 2-4 weeks

  17. Would recommend abortion method to a friend, by gestational age group

    Measured: 2-4 weeks

  18. Proportion of participants who saw products of pregnancy, by gestational age group

    Measured: 2-4 weeks

  19. Proportion of participants who saw products of pregnancy who reported feelings as: nothing/no feeling, relieved, sad, uncomfortable, other, by gestational group

    Measured: 2-4 weeks

  20. Received family planning by follow-up visit, by gestational age group / method type/ pregnancy intention

    Measured: 2-4 weeks

  21. Know where to get contraceptive supplies in the future, by gestational age group and pregnancy intention

    Measured: 2-4 weeks

  22. Did not receive a contraceptive method by follow-up visit, but don't want to get pregnant in next 12 months, by gestational age group

    Measured: 2-4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Apr 2016 (estimated)
  2. Study startSep 2016
  3. Primary completionDec 2016 (estimated)
  4. Study completionDec 2016 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
648 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02745093
Sponsor's protocol ID
MSI-6103
Status last verified
Jun 2016
First submitted
7 Aug 2015
Last updated
20 Jun 2016
Results posted
No
Data monitoring committee
No

Publications

  • Boersma AA, Meyboom-de Jong B, Kleiverda G. Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curacao. Eur J Contracept Reprod Health Care. 2011 Apr;16(2):61-6. doi: 10.3109/13625187.2011.555568. Epub 2011 Feb 9.

    PubMed 21303309
  • Chen MJ, Creinin MD. Mifepristone With Buccal Misoprostol for Medical Abortion: A Systematic Review. Obstet Gynecol. 2015 Jul;126(1):12-21. doi: 10.1097/AOG.0000000000000897.

    PubMed 26241251
  • Gomperts R, van der Vleuten K, Jelinska K, da Costa CV, Gemzell-Danielsson K, Kleiverda G. Provision of medical abortion using telemedicine in Brazil. Contraception. 2014 Feb;89(2):129-33. doi: 10.1016/j.contraception.2013.11.005. Epub 2013 Nov 12.

    PubMed 24314910
  • Gouk EV, Lincoln K, Khair A, Haslock J, Knight J, Cruickshank DJ. Medical termination of pregnancy at 63 to 83 days gestation. Br J Obstet Gynaecol. 1999 Jun;106(6):535-9. doi: 10.1111/j.1471-0528.1999.tb08320.x.

    PubMed 10426609
  • Hamoda H, Ashok PW, Flett GM, Templeton A. Medical abortion at 9-13 weeks' gestation: a review of 1076 consecutive cases. Contraception. 2005 May;71(5):327-32. doi: 10.1016/j.contraception.2004.10.015.

    PubMed 15854631
  • Hamoda H, Ashok PW, Flett GM, Templeton A. A randomised controlled trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion up to 13 weeks of gestation. BJOG. 2005 Aug;112(8):1102-8. doi: 10.1111/j.1471-0528.2005.00638.x.

    PubMed 16045525
  • Kulier R, Kapp N, Gulmezoglu AM, Hofmeyr GJ, Cheng L, Campana A. Medical methods for first trimester abortion. Cochrane Database Syst Rev. 2011 Nov 9;2011(11):CD002855. doi: 10.1002/14651858.CD002855.pub4.

    PubMed 22071804
  • Ngo TD, Park MH, Shakur H, Free C. Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review. Bull World Health Organ. 2011 May 1;89(5):360-70. doi: 10.2471/BLT.10.084046. Epub 2011 Mar 4.

    PubMed 21556304
  • Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd edition. Geneva: World Health Organization; 2012. Available from http://www.ncbi.nlm.nih.gov/books/NBK138196/

    PubMed 23700650
  • Winikoff B, Dzuba IG, Chong E, Goldberg AB, Lichtenberg ES, Ball C, Dean G, Sacks D, Crowden WA, Swica Y. Extending outpatient medical abortion services through 70 days of gestational age. Obstet Gynecol. 2012 Nov;120(5):1070-6. doi: 10.1097/aog.0b013e31826c315f.

    PubMed 23090524

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Mifepristone and Misoprostol in people with Medical Abortion, run by Ibis Reproductive Health at 3 sites in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 20 Jun 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Antonio Candelas (++ 52 55 5265 5041, antonio.candelas@mariestopes.org.mx), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of participants with complete abortion without surgical intervention by day 30 from mifepristone administration, regardless of misoprostol dosing, by gestational age group (time frame: 2-4 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02745093, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jun 2016.

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