Add-on letrozole provides no added benefit in medication abortion

Adding a single dose of letrozole to misoprostol does not appear to improve the efficacy of the latter for medical termination of pregnancy, as shown in a study.

The study involved 40 pregnant women (median age 25 years) who were seeking medication abortion up to 63 days’ gestation. All of them received a single dose of letrozole 30 mg in-clinic. Two days after, they took misoprostol 800 mcg buccally at home. A second dose of misoprostol was allowed in case of the absence of bleeding within 24 hours of the first dose.

Researchers assessed outcomes and side effects at days 7–10. Outcome data were available for 39 women.

A total of 29 women (74 percent) achieved a complete abortion, while four women (10 percent) had an incomplete abortion and opted for aspiration. Meanwhile, six women (15 percent) had an ongoing pregnancy at follow-up.

All 39 women with follow-up data reported taking the first dose of misoprostol. Moreover, out of the 10 women (27 percent) who took the second misoprostol dose, only three did so due to no bleeding.

In terms of safety, 19 women (51 percent) developed side effects following intake of letrozole and prior to the first misoprostol dose, with two of them (5 percent) rating the side effects as severe. Side effects following misoprostol was documented in 33 participants (89 percent), with the side effects profile consistent with published reports. None of the women developed serious adverse events.