Antiprogestogen

{{Short description|Class of compounds}} {{cs1 config|name-list-style=vanc|display-authors=6}} {{Infobox drug class | Image = Mifepristone_structure.svg | ImageClass = skin-invert-image | Alt = | Caption = Mifepristone, an antiprogestogen that is used to induce medical abortions. | Width = 250px | Synonyms = Antiprogestins; Progesterone antagonists; Progesterone blockers  | Use = Medical abortion, emergency contraception, uterine fibroids | ATC_prefix = G03XB | Biological_target = Progesterone receptor | Chemical_class = Steroidal  | Drugs.com = | Consumer_Reports = | medicinenet = | rxlist =  | MeshID = }}

'''Antiprogestogens''' or '''antiprogestins''', also known as '''progesterone antagonists''' or '''progesterone blockers''', are a class of drugs which prevent progestogens like progesterone from mediating their biological effects in the body. These drugs competitively inhibit progestin at progesterone receptors, acting by blocking the progesterone receptor (PR) and/or inhibiting or suppressing progestogen production. Antiprogestogens are one of three types of sex hormone antagonists, alongside antiestrogens and antiandrogens.<ref name="Nath2006">{{cite book| vauthors = Nath JL |title=Using Medical Terminology: A Practical Approach|url=https://books.google.com/books?id=UEvTZg_5FBIC&pg=PA977|year=2006|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-4868-1|pages=977–}}</ref>

== Clinical applications ==

Antiprogestogens are used as abortifacients, emergency contraceptives, and in the treatment of uterine fibroids. They are also being studied in the treatment of breast cancer. Examples include the progesterone receptor weak partial agonist mifepristone, the selective progesterone receptor modulator (SPRM) ulipristal acetate, and the silent antagonist aglepristone.<ref name="Spitz-2006">{{cite journal | vauthors = Spitz IM | title = Progesterone receptor antagonists | journal = Current Opinion in Investigational Drugs | volume = 7 | issue = 10 | pages = 882–890 | date = October 2006 | pmid = 17086932 }}</ref><ref name="Tang-2006">{{cite journal | vauthors = Tang OS, Ho PC | title = Clinical applications of mifepristone | journal = Gynecological Endocrinology | volume = 22 | issue = 12 | pages = 655–659 | date = December 2006 | pmid = 17162706 | doi = 10.1080/09513590601005946 | s2cid = 23295715 }}</ref> In medical abortion, mifepristone is combined with a prostaglandin (e.g., gemeprost), while ulipristal is used for emergency contraception.<ref name="Le_2023">{{cite book | vauthors = Le T, Bhushan V, Qiu C, Chalise A, Kaparaliotis P |title= First aid for the USMLE step 1 |date=2023 |publisher=McGraw Hill | isbn = 978-1-264-94662-4 }}</ref>

== Development and approval ==

Several hundred antiprogestogens have been developed, but only three—mifepristone, lilopristone, and onapristone—have been administered to humans. Of these, only mifepristone has been approved and introduced for clinical use.<ref name="BourneCondous2006">{{cite book| vauthors = Nielsen S, Granberg S | chapter = The expectant management of miscarriage | veditors = Bourne TH, Condous G |title=Handbook of Early Pregnancy Care| chapter-url=https://books.google.com/books?id=_Y3PyNvc6dcC&pg=PA41|date=17 October 2006|publisher=CRC Press|isbn=978-0-203-01621-3|pages=37–50 (41) }}</ref>

== Role and mechanism of action ==

Progestins, including progesterone, are vital for preparing the uterus for the implantation of a fertilized egg during the luteal phase of the menstrual cycle. If fertilization, implantation, and other events necessary for pregnancy occur, increased progestin (i.e., progesterone) levels are essential in maintaining the pregnancy. Blocking the effects of progestins like progesterone is associated with anti-gestational effects, resulting in the interruption of pregnancy maintenance.<ref name="Le_2023" />

== See also == *Antiestrogen *Antiandrogen

== References == {{Reflist|2}}

== External links == *{{Commonscatinline|Antiprogestogens}} *[http://www.cancer.gov/dictionary?CdrID=561317 Antiprogestin] entry in the public domain NCI Dictionary of Cancer Terms {{NCI-cancer-dict}}

Category:Antiprogestogens