Research and Technology

25.08.20

NIHR research finds more effective drug treatment for miscarriage

As part of new research from an NIHR-funded study by the Tommy’s National Centre for Miscarriage Research, a new drug combination has been found to be more effective for women having miscarriages without symptoms than current standard NHS treatment.

Missed miscarriage, also sometimes known as delayed or silent miscarriage, is when a pregnancy has ended in the womb but the mother may not have had any typical symptoms such as pain or bleeding.

Under national guidance, a treatment called misoprostol is recommended – which is successful in most cases, but can sometimes lead to a several-week wait, repeating the medication or eventually requiring surgery.

According to the new research, when combined with another medicine, an anti-progesterone drug called mifepristone, the same misoprostol treatment shows to be more effective.

READ MORE: Four new NIHR Incubators formed to support academic research

Tommy’s researchers at the University of Birmingham studied a total of 711 women across 28 UK hospitals with a diagnosis of missed miscarriage in the first 14 weeks of pregnancy, randomly assigning them to receive either the mifepristone drug or a placebo followed by misoprostol two days later. Researchers then saw a 7% increase in the miscarriage resolution rate in the group given the drug combination when compared to the placebo group.

The need for surgery was significantly reduced too, with only 17% of those taking the drug combination requiring surgical intervention, compared to 25% in the placebo group.

Further analysis is now being conducted to investigate how much money could be saved by healthcare providers by switching to the combined treatment, though early indicators appear to suggest it would be more cost-effective for the NHS and better for patient outcomes.

The study was the largest ever conducted into the most effective medical treatments for missed miscarriage, with calls now for the National Institute for Health and Care Excellence (NICE) guidance to be updated accordingly.

READ MORE: NIHR reaffirms commitment to health research transparency

Dr Justin Chu from Tommy’s National Centre for Miscarriage Research, who led the study at the University of Birmingham’s Clinical Trials Unit, commented: “Particularly given the extra strain on the NHS in the Covid-19 pandemic, our findings could have huge benefits if they’re translated into clinical practice.

“We could achieve better outcomes for women and lower costs for care services.

“We hope the NICE guidance will be updated in light of this new evidence, so that everyone who needs it has access to the most effective treatment.”

Professor Andy Shennan, Professor of Obstetrics, and Clinical Director NIHR Clinical Research Network South London, added: “This important NIHR-funded study presents compelling results indicating more effective treatments that can help women have better outcomes after miscarriage.

“The fact that the need for surgery is reduced using this new combination of drugs is a positive result for both patients and those who plan and provide NHS care services.”

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