methotrexate to be trialed in Australia for abortions

<http://www.theage.com.au/news/National/Cancer-drug-used-to-perform-abortions/2006/07/04/1151778906397.html>

Cancer drug used to perform abortions

July 4, 2006 - 9:19AM


Australia's drug regulator says doctors are allowed to use a cancer
treatment to perform abortions, amid denials that government pressure is
preventing access to the abortion pill RU486.

Delays in obtaining RU486 in Australia have prompted abortion provider
Marie Stopes International to trial the use of methotrexate, used to treat
breast cancer and leukaemia, as an alternative.

Marie Stopes will begin the trial in Sydney next month and will treat 100
women in the early stages of pregnancy with methotrexate, combined with
four follow-up doses of a drug used to treat stomach ulcers, misoprostol.

If the trial is successful, the treatment will be used at the company's
eight clinics in NSW, the ACT, Queensland and WA.

The Therapeutic Goods Administration (TGA) said methotrexate was
registered and used safely in Australia as a cancer treatment, but had not
been approved as an abortion pill.

Despite this, doctors were free to prescribe the drug for terminations.

"Once a drug is approved it's up to the medical profession how it's used,"
TGA spokeswoman Kay McNiece said.

"It's approved for a specific use but doctors are able to use any drug
off-label with the informed consent of their patients."

A conscience vote in the federal parliament five months ago stripped the
health minister of the power to veto RU486, clearing the way for the TGA
to licence the drug's use in Australia.

But Marie Stopes International senior doctor Philip Goldstone said no
pharmaceutical company had applied to licence and import RU486, leaving it
up to individuals to apply to import the drug.

"The process of application to the Therapeutic Goods Administration by an
individual is a very long-winded process which can take months, if not
years, and we have a drug that is available now," he told ABC Radio.

"That's why we have chosen to use the methotrexate option."

Prime Minister John Howard, who voted against lifting the ministerial
control over RU486, has rejected suggestions his government had warned
pharmaceutical companies against trying to get the drug licensed in
Australia.

"I'm not applying any pressure and I'm not aware of any pressure being
applied by any minister," Mr Howard told Southern Cross Broadcasting.

"I accept the verdict of parliament, although I voted differently in a
free vote."

Doctors said methotrexate was safe to use in terminations up to 12 weeks,
although it was not as effective as RU486.

"We use it for ectopic pregnancies and we can use it as a chemotherapeutic
agent to kill cancer cells - it stops the cells dividing and multiplying,"
Australian Medical Association obstetrics and gynaecology spokesman Andrew
Pesce said.

"I've never used it for an abortion but there is quite a good base of
knowledge from overseas of its use. It's useful where RU486 isn't
available."

Dr Pesce said methotrexate would not be used widely in abortions as most
women opted for surgical terminations.

A spokeswoman for Health Minister Tony Abbott said doctors would have to
weigh up the risks involved in giving patients a drug that had not been
approved for use in Australia as an abortion pill.

"It's not registered to be used for abortions so doctors will be doing
that based on what they think they can do," she said.

Opposition health spokeswoman Julia Gillard said women should be able to
use methotrexate to have an abortion, provided the drug was safe.

© 2006 AAP

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