Comparison of Two Different Drug Regimens for Medical Treatment of Early Pregnancy Loss

NCT ID: NCT05124314

Last Updated: 2021-11-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-27

Study Completion Date

2023-10-31

Brief Summary

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The purpose of this study is to compare the safety and efficacy of a combination of two drugs (mifepristone and misoprostol) to only one of these drugs (misoprostol) in medical management of missed miscarriage up to 13+6 weeks of pregnancy (early pregnancy loss).

The investigators aim to enroll 220 patients within two years which would be enough to determine the difference between these two treatments with confidence.

Detailed Description

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Aim: To investigate the safety and efficacy of combination of mifepristone and misoprostol versus misoprostol alone in medical management of early pregnancy loss.

Primary objective: To test the hypothesis that the sequential combination of mifepristone and misoprostol is superior to misoprostol alone for the complete evacuation of uterus in patients diagnosed with early pregnancy loss.

Secondary objectives: To test the hypothesis that the addition of mifepristone reduces the need for further doses of misoprostol, duration of bleeding, complication rate and side effect frequency. The investigators will also evaluate if the addition of mifepristone improves patient satisfaction and quality of life.

Women with a diagnosis of early pregnancy loss that opt for medical treatment and sign an informed consent will be included. The participants will be randomized to two groups. First group will receive oral mifepristone (600 mg) and the second group will not. The remaining course of treatment will be the same for both groups including giving misoprostol (800 mcg vaginally) 48 hours after receiving mifepristone for the first group or immediately for the second group. 24 hours after receiving first dose of misoprostol, one more dose of misoprostol (also 800 mcg vaginally) will be given if no pregnancy tissue is lost.

Three weeks after medical treatment, primary and secondary outcomes will be assessed. In case of unsuccessful treatment (incomplete evacuation of uterus), surgical evacuation will be performed.

220 women will be randomized in a 1:1 ratio.

Conditions

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Abortion, Missed

Keywords

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Missed miscarriage Mifepristone Misoprostol Medical management

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized, parallel group, single center study. Before receiving vaginal misoprostol (800 mcg, repeated after 24 hours if no pregnancy tissue is lost), patients will be randomized to either oral mifepristone (600 mg) or nothing.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Mifepristone and Misoprostol

Patients receive oral mifepristone (600 mg) 48 hours before medical treatment with vaginal misoprostol (800 mcg repeated after 24 hours if no pregnancy tissue is lost).

Group Type EXPERIMENTAL

Mifepristone, Oral, 200 Mg

Intervention Type DRUG

Adding 600 mg of oral Mifepristone to the regular treatment with vaginal Misoprostol 800 mcg

Misoprostol Pill

Intervention Type DRUG

Regular treatment with vaginal Misoprostol 800 mcg

Misoprostol

Medical treatment with vaginal misoprostol (800 mcg repeated after 24 hours if no pregnancy tissue is lost).

Group Type ACTIVE_COMPARATOR

Misoprostol Pill

Intervention Type DRUG

Regular treatment with vaginal Misoprostol 800 mcg

Interventions

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Mifepristone, Oral, 200 Mg

Adding 600 mg of oral Mifepristone to the regular treatment with vaginal Misoprostol 800 mcg

Intervention Type DRUG

Misoprostol Pill

Regular treatment with vaginal Misoprostol 800 mcg

Intervention Type DRUG

Other Intervention Names

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Mifegyne Mispregnol

Eligibility Criteria

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Inclusion Criteria

* Women diagnosed with missed miscarriage in the first 13+6 weeks of pregnancy opting for medical management
* Age 18 years and older
* Intra-uterine pregnancy
* Hemodynamically stable patient
* No signs of infection
* No signs of incomplete miscarriage
* Willing and able to give informed consent

Exclusion Criteria

* Women opting for alternative methods of miscarriage management (expectant or surgical)
* Diagnosis of incomplete miscarriage
* Life threatening bleeding
* Hemodynamically unstable patient
* Contraindications to mifepristone or misoprostol use for example chronic adrenal failure, known hypersensitivity to either drug, haemorrhagic disorders and anticoagulant therapy, prosthetic heart valve or history of endocarditis, existing cardiovascular disease, severe asthma uncontrolled by therapy or inherited porphyria
* Previous participation in this trial
* Unable to give informed consent
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Zagreb School of Medicine

UNKNOWN

Sponsor Role collaborator

Clinical Hospital Merkur

OTHER

Sponsor Role lead

Responsible Party

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Mate Milas

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mate Milas, MD

Role: PRINCIPAL_INVESTIGATOR

Clinical Hospital Merkur

Locations

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Clinical Hospital Merkur

Zagreb, City of Zagreb, Croatia

Site Status RECRUITING

Countries

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Croatia

Central Contacts

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Mate Milas, MD

Role: CONTACT

Phone: +385992060290

Email: [email protected]

Facility Contacts

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Mate Milas, MD

Role: primary

Other Identifiers

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2021-0001

Identifier Type: -

Identifier Source: org_study_id