"Magic Bullet"

Japanese abortion drug stirs hopes and questions

It has long been a dream of population-control experts, to say nothing of millions of men and women all over the world: a safe antidote that can be taken after intercourse to prevent pregnancy. Such a perfect morning-after pill still eludes medical science. But Japanese researchers believe they have developed the next-best thing, a vaginal suppository. If administered as early as two weeks after a woman has missed her period because of pregnancy, it can induce abortion about 90% of the time with barely any side effects.

Produced by Osaka's Ono Pharmaceutical Co., the new suppository drug is based on one of the prostaglandins, hormone-like compounds once believed to originate in the male prostate gland. Researchers have long realized that certain prostaglandins could induce contractions in smooth muscles, including those of the womb. Soon doctors were using them to speed up labor in difficult births and to induce abortion when other techniques had failed, or seemed unsuitable. Yet such abortifacients (as these drugs are called) had serious shortcomings. Usually administered intravenously, they often caused stomach pain, nausea, vomiting, diarrhea and other physical problems. Thus pharmaceutical firms have looked for artificial variants without side effects that could be delivered directly into the vagina.

On their 802nd try, researchers at Ono created Ono 802. In the first trial on pregnant volunteers, reports Dr. Shigeo Takagi of Tokyo's Nihon University School of Medicine, the drug within a week completely aborted 86% of his patients who had missed their period for twelve to 37 days. Bleeding usually began within six to eight hours after the drug was administered (in the form of three to five waxy, bullet-shaped white suppositories inserted one at a time into the vagina at three-hour intervals). The World Health Organization has given its blessings to more widespread clinical trials for the drug. If it proves safe and reliable, WHO officials feel it can help to contain an exploding global population. Some medical questions must be settled as well. An overdose of a powerful abortifacient may possibly have serious consequences. For this and other reasons, strict limits have been placed on a similar second-trimester vaginal suppository, Prostin E2, which the Upjohn Co. made available in the U.S. last November. It is distributed only to qualified doctors and hospitals for cases where such drug-induced abortion seems preferable to other methods of terminating pregnancy.

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