RU486 e infezioni: un primo bilancio

Dopo la conclusione del convegno sponsorizzato dalla FDA e dedicato alle infezioni da batteri del genere Clostridium, comprese quelle avvenute in America del Nord dopo la somministrazione della pillola abortiva, un primo bilancio dei risultati ottenuti viene fornito da Susan F. Wood, che fino all’anno scorso ricopriva un incarico direttivo alla FDA. La Wood ha reso una testimonianza il 17 maggio scorso di fronte al Subcommittee on Criminal Justice, Drug Policy, and Human Resources, Committee on Government Reform, della Camera dei Rappresentanti del Congresso Usa.

the close surveillance of adverse events associated with the use of mifepristone have alerted us that this bacterial infection is present and has caused the deaths of other women who have given birth or had a miscarriage – more in fact than the number of women who underwent a medical abortion … to focus solely on women who have had a medical abortion is to miss the real threat to the health of women. … With mifepristone we can be confident that we have identified all or most of the adverse events and deaths. We cannot say the same for infections and deaths caused by C. sordellii in women who have given birth or had a miscarriage. …
Questions have been raised about whether mifepristone is involved through suppression of the immune system. This is a question to be studied, but at this point does not seem to be a compelling mechanism. If the immune system were suppressed, we would also expect to see a rise in other more common infections. Also, although progesterone suppresses the immune system normally in pregnancy, mifepristone is an anti-progestin and might be expected to counter this normal suppression of the immune system. We would also expect to have seen this infection in places using the higher doses of mifepristone, but, in fact, use in the US is of a much lower dose (usually one-third) than that commonly used in Europe. Similarly we would expect to see this infection in cancer patients who have used mifepristone over longer periods of time. This pattern thus far has not emerged.
Experts at CDC, FDA and NIH reviewed the current information and appeared to recognize that the infections and deaths due to C. sordellii are not due to a simple drug effect. Rather this is a complex situation that involves multiple factors that are linked to pregnancy.