Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis

@article{Glasier2010UlipristalAV,
  title={Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis},
  author={Anna Glasier and Sharon Tracey Cameron and Paul E. M. Fine and Susan J. Logan and William Casale and Jennifer Van Horn and Laszlo Sogor and Diana L Blithe and Bruno Scherrer and Henri Camille Mathe and Amelie Jaspart and André Ulmann and Erin Gainer},
  journal={The Lancet},
  year={2010},
  volume={375},
  pages={555-562}
}
BACKGROUND Emergency contraception can prevent unintended pregnancies, but current methods are only effective if used as soon as possible after sexual intercourse and before ovulation. [...] Key MethodMETHODS Women with regular menstrual cycles who presented to a participating family planning clinic requesting emergency contraception within 5 days of unprotected sexual intercourse were eligible for enrolment in this randomised, multicentre, non-inferiority trial.Expand
Efficacy of ulipristal acetate for emergency contraception and its effect on the subsequent bleeding pattern when administered before or after ovulation.
STUDY QUESTION Does ulipristal acetate (UPA) have similar efficacy as emergency contraception (EC) when administered before and after ovulation? SUMMARY ANSWER The efficacy of UPA-EC wasExpand
ULIPRISTAL ACETATE- A NOVEL ORAL EMERGENCY CONTRACEPTIVE: HYPE OR HOPE?
TLDR
Ulipristal acetate although provides women and health-care providers with an effective alternative for emergency contraception extended up to 5 days post-unprotected intercourse or contraceptive failure, further long term evidence is warranted before a change in practice should be entertained. Expand
A randomized, double-blind, noninferiority study to compare two regimens of levonorgestrel for emergency contraception in Nigeria.
TLDR
This study shows the simplified emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen among Nigerian women. Expand
Ulipristal Acetate: A New Emergency Contraceptive that is Safe and More Effective than Levonorgestrel
TLDR
A recent meta-analysis of two randomized clinical trials showed UPA to have a pregnancy risk 42% lower than LNG up to 72 h, and 65% lower in the first 24 h following unprotected intercourse. Expand
Use of ulipristal acetate and levonorgestrel for emergency contraception: a follow-up study
TLDR
There was a significant increase in women using UPA for EC compared with the previous study, particularly among those wishing to use condoms for continuing contraception. Expand
Ulipristal acetate for emergency contraception: postmarketing experience after use by more than 1 million women.
TLDR
Use of ulipristal acetate for emergency contraception in a variety of settings and among diverse populations indicate that it is safe and without unexpected or serious adverse events. Expand
Ulipristal acetate prevents ovulation more effectively than levonorgestrel: analysis of pooled data from three randomized trials of emergency contraception regimens.
TLDR
Although no EC treatment is 100% effective in inhibiting follicular rupture when administered in the late follicular phase, UPA is the most effective treatment, delaying ovulation for at least 5 days in 59% of the cycles. Expand
Emergency contraception: potential role of ulipristal acetate
TLDR
Evidence is provided that UPA, a new type of second-generation progesterone receptor modulator, represents a new evolutionary step in EC treatment and is in line with results from a series of clinical trials conducted recently which demonstrate that U PA seems to have higher EC efficacy compared to LNG. Expand
Original research article Preference for and efficacy of oral levonorgestrel for emergency contraception with concomitant placement of a levonorgestrel IUD: a prospective cohort study ☆,☆☆,★,★★,☆☆☆,★★★,☆☆☆☆
TLDR
Consideration should be given to LNG IUD insertion with concomitant use of oral LNG 1.5 mg with the LNG 52 mg IUD over the copper IUD in EC counseling to increase the number of EC users who opt to initiate highly effective reversible contraception. Expand
Ulipristal acetate compared to levonorgestrel emergency contraception among current oral contraceptive users: a cost-effectiveness analysis.
TLDR
UPA was the optimal method of oral EC, as it resulted in 720 fewer unintended pregnancies, 736 fewer abortions and 80 fewer deliveries at a total cost savings of $50,323 and 79 additional adjusted life-years. Expand
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References

SHOWING 1-10 OF 46 REFERENCES
Ulipristal Acetate Taken 48–120 Hours After Intercourse for Emergency Contraception
TLDR
Ulipristal acetate is effective and well-tolerated for emergency contraception 48–120 hours after unprotected intercourse, and this results satisfy the protocol-defined statistical criteria for success. Expand
Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception
TLDR
The levonorgestrel regimen was better tolerated and more effective than the current standard in hormonal emergency contraception and declined with increasing time since unprotected coitus. Expand
Progesterone Receptor Modulator for Emergency Contraception: A Randomized Controlled Trial
TLDR
CDB-2914 is at least as effective as levonorgestrel in preventing pregnancies after unprotected intercourse and has a similar side effect profile. Expand
Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multicentre randomised trial
TLDR
The three regimens studied are very efficacious for emergency contraception and prevent a high proportion of pregnancies if taken within 5 days of unprotected coitus, and most women menstruated within 2 days of the expected date. Expand
Timing of emergency contraception with levonorgestrel or the Yuzpe regimen
TLDR
The consistency between the WHO trial and an earlier randomized controlled trial the statistically significant temporal effect observed with both treatment regimens and biologic plausibility all suggest that the effect of timing on emergency contraception efficacy is real. Expand
Emergency contraception with levonorgestrel or the Yuzpe regimen
TLDR
The authors investigated the impact of time elapsed since unprotected intercourse on the efficacy of emergency contraception in more detail and found that a levonorgestrel-only regimen was consistently more effective than the Yuzpe regimen. Expand
Interventions for emergency contraception.
TLDR
Mifepristone middle dose (25-50 mg) was superior to other hormonal regimens and Levonorgestrel was more effective than the Yuzpe regimen in preventing pregnancy. Expand
Impact of Increased Access to Emergency Contraceptive Pills: A Randomized Controlled Trial
TLDR
This intensive strategy to enhance access to emergency contraceptive pills substantially increased use of the method and had no adverse impact on risk of sexually transmitted infections, however, it did not show benefit in decreasing pregnancy rates. Expand
Pituitary-ovarian function following the standard levonorgestrel emergency contraceptive dose or a single 0.75-mg dose given on the days preceding ovulation.
TLDR
In conclusion, LNG can disrupt the ovulatory process in 93% of cycles treated when the diameter of the dominant follicle is between 12 and 17 mm, and the present data suggest that half the dose may be as effective as the standard dose. Expand
Advance provision of emergency contraception for pregnancy prevention: a meta-analysis.
TLDR
Advance provision of emergency contraception did not reduce pregnancy rates and did not negatively affect sexual and reproductive health behaviors and outcomes compared with conventional provision. Expand
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