Ulipristal acetate in emergency contraception [Ulipristat acetat u hitnoj kontracepciji]

Šprem Goldštajn, Marina and Pavičić Baldani, Dinka and Škrgatić, Lana and Radaković, Branko and Vrčić, Hrvoje and Čanić, Tomislav (2014) Ulipristal acetate in emergency contraception [Ulipristat acetat u hitnoj kontracepciji]. Collegium Antropologicum, 38 (1). pp. 379-384. ISSN 0350-6134

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Abstract

Despite the widespread availability of highly effective methods of contraception, unintended pregnancy is common. Unplanned pregnancies have been linked to a range of health, social and economic consequences. Emergency contraception reduces risk of pregnancy after unprotected intercourse, and represents an opportunity to decrease number of unplanned pregnancies and abortions. Emergency contraception pills (ECP) prevent pregnancy by delaying or inhibiting ovulation, without interfering with post fertilization events. If pregnancy has already occurred, ECPs will not be effective, therefore ECPs are not abortificants. Ulipristal acetate (17alpha-acetoxy-11beta-(4N-N,N-dymethilaminophenyl)-19-norpregna--4,9-diene-3,20-dione) is the first drug that was specifically developed and licensed for use as an emergency contraceptive. It is an orally active, synthetic, selective progesterone modulator that acts by binding with high affinity to the human progesterone receptor where it has both antagonist and partial agonist effects. It is a new molecular entity and the first compound in a new pharmacological class defined by the pristal stem. Up on the superior clinical efficacy evidence, UPA has been quickly recognized as the most effective emergency contraceptive pill, and recently recommended as the first prescription choice for all women regardless of the age and timing after intercourse. This article provides literature review of UPA and its role in emergency contraception.

Abstract in Croatian

Unatoč dostupnosti vrlo učinkovitih metoda kontracepcije, učestalost neželjenih trudnoća vrlo je visoka. Neplanirane trudnoće dovode do niza zdravstvenih rizika, te nose socijalne i ekonomske posljedice. Hitna kontracepcija umanjuje rizik od trudnoće nakon nezaštićenog spolnog odnosa, i predstavlja mogućnost za smanjenje broja neplaniranih trudnoća i pobačaja. Pilule za hitnu kontracepciju (eng. emergency contraceptive pill, ECP) spriječavaju trudnoću odgađajući ili inhibirajući ovulaciju, bez interferencije sa postfertilizacijskim procesom. Ukoliko je do trudnoće već došlo, ECP neće biti učinkovita. Stoga se ECP ne smatraju abortivnim sredstvima. Ulipristal acetat (UPA) (17alpha-acetoksi-11beta-(4N-N, N-dymethilaminophenyl)-19-norpregna-4,9-dien-3,20-dion) je prvi lijek koji je posebno razvijen i licenciran za upotrebu kao hitni kontraceptiv. Ulipristal acetat je oralno aktivni, sintetički, selektivni modulator progesteronskih receptora koji djeluje vežući se s visokim afinitetom za humani receptor za progesteron. Posjeduje i antagonističke i parcijalno agonističke učinke. Ulipristal acetat se smatra novim molekularnim entitetom i prvom komponentom farmakološke klase definirane kao pristalna osnova. S obzirom na dokazan klinički superioran učinak, UPA je brzo prepoznat kao najučinkovitije sredstvo za hitnu kontracepciju, te je nedavno preporučen kao lijek prvog izbora za sve žene bez obzira na dob. Ovaj članak daje pregled literature o UPA i njegovoj ulozi u hitnoj kontracepciji.

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