Retrospective cohort study on the efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy
- VernacularTitle:甲氨蝶呤联合米非司酮治疗异位妊娠效果的回顾性队列研究
- Author:
Yi LIU
1
;
Zhiyong YANG
1
;
Qier WANG
2
;
Yunfei XIE
3
Author Information
1. Dept. of Pharmacy，the Affiliated Hospital of Chengdu University，Chengdu 610081，China
2. Dept. of Obstetrics and Gynecology，the Affiliated Hospital of Chengdu University，Chengdu 610081，China
3. Dept. of Nuclear Medicine，Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital，Chengdu 610072，China
- Publication Type:Journal Article
- Keywords:
methotrexate;
mifepristone;
propensity score matching;
ectopic pregnancy;
second pregnancy;
efficacy;
economy
- From:
China Pharmacy
2023;34(4):471-475
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the efficacy of Methotrexate （MTX） injection combined with Mifepristone tablets in the treatment of ectopic pregnancy. METHODS A retrospective cohort study method was used to collect data on patients with ectopic pregnancy who visited the Affiliated Hospital of Chengdu University from January 1， 2013 to December 31， 2021. Control group was given MTX injection alone， and exposure group was given MTX injection combined with Mifepristone tablets. Baseline variables were balanced between the two groups using a propensity score matching （PSM）， and the outcomes of the matched cohorts were compared. RESULTS A total of 125 patients were included， involving 68 in the control group and 57 in the exposure group. After PSM， 46 cases in each group were successfully matched. There was no significant difference in the treatment response rate and the incidence of adverse drug reaction （ADR） between the exposure group and the control group， which were 73.91% and 63.04%， 21.74% and 13.04% （P＞0.05）. Compared with before treatment， serum levels of β-HCG were all significantly decreased in 2 groups after treatment （P＜0.05）； there was no significant difference in the serum level of β-HCG after treatment， the time to return to normal， the interval time of second pregnancy， second ectopic pregnancy and second intrauterine pregnancy between 2 groups （P＞0.05）. The mean diameter difference of B-ultrasound pregnancy mass before and after treatment， duration of clinical symptom remission and length of hospital stay in the exposure group were significantly higher than those in the control group （P＜ 0.05）， but drug costs during hospitalization and total hospitalization costs were not significantly increased （P＞0.05）. There were no significant difference between single-dose group and multi-dose group of MTX in the treatment response rate and the incidence of ADR （P＞0.05）. The hospitalization time， drug cost and total cost of the single dose group were significantly less than those of the multi-dose group （P＜0.05）. CONCLUSIONS MTX injection combined with or without Mifepristone tablet can both effectively treat ectopic pregnancy， with comparable efficacy and safety. MTX single-dose regimen is similar to the multi-dose regimen in efficacy， but the multi-dose regimen increases the hospital stay and hospitalization costs.
