Mifepristone
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Mifepristone: From Pregnancy Termination to Punctate Epithelial Keratoconjunctivitis
One-Sentence Summary
Mifepristone was originally used for pregnancy disorders with an abortive outcome (medical termination of pregnancy). The TxGNN model predicts it may be effective for punctate epithelial keratoconjunctivitis, but there are currently 0 clinical trials and 0 publications supporting this direction, so the prediction rests on the computational model alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Pregnancy disorder with abortive outcome (from the knowledge graph; the Singapore licence text is blank) |
| Predicted New Indication | Punctate epithelial keratoconjunctivitis |
| TxGNN Prediction Score | 97.60% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 1 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on general pharmacology, mifepristone is a glucocorticoid receptor and progesterone receptor antagonist. Its efficacy in its original indication is established, but the data compiled for this report do not describe how it works.
A possible, purely speculative link is that blocking glucocorticoid receptor signalling could change inflammation on the ocular surface. Nothing in the compiled data supports this. Glucocorticoids are themselves used to reduce eye inflammation, so antagonising their receptor could just as plausibly worsen the condition. The high score (97.60%) is a computational prediction only and should not be read as evidence of efficacy.
Other conditions ranked by the model include rosacea (97.17%), otitis externa (96.65%), post-bacterial disorder (96.65%), postinfectious vasculitis (96.61%), infective urethral stricture (96.56%), post-infectious syndrome (96.54%), Chagas cardiomyopathy (96.45%), infection-related haemolytic uraemic syndrome (96.42%) and parasitic eyelid infestation (92.82%). None has any supporting trial or publication in the compiled data. Many are infection-related, for which mifepristone has no known anti-infective mechanism.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN15583P | MIFEGYNE TABLETS 200MG (Laboratoires MACORS) | Tablet (oral) | Not stated in the compiled data |
Safety Considerations
- Contraindication signals from the knowledge graph (these come from drug-disease relationship data, not from package insert text):
- Adrenal conditions: adrenocortical insufficiency, Addison disease, adrenal insufficiency
- Blood coagulation disease
- Porphyrias: hepatic porphyria, variegate porphyria, porphyria cutanea tarda (familial and sporadic), inherited porphyria, inborn disorder of porphyrin metabolism, erythropoietic protoporphyria (including the autosomal form), acute intermittent porphyria
- Infectious disease
- Ectopic pregnancy
- Drug Interactions: 100 interactions were found. The sample reviewed included:
- Major: hydrocortisone, triamcinolone, dexamethasone, beclomethasone dipropionate, betamethasone, budesonide, clarithromycin, dolasetron
- Moderate: famotidine, pioglitazone, loperamide, bupropion, aprepitant, bisacodyl, budesonide (nasal), chlorpropamide, cimetidine, picosulfuric acid, polyethylene glycol (3350 with electrolytes), saxagliptin
The many major interactions with corticosteroids are relevant because mifepristone blocks glucocorticoid receptors and could reduce their effect.
Please refer to the package insert for warnings and further safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has no supporting clinical trials or publications (Evidence Level L5), and no mechanistic link is established. The knowledge graph flags several contraindications, including infectious disease, and mifepristone interacts strongly with corticosteroids, which are commonly used in eye and skin conditions.
To proceed, the following is needed:
- Mechanism of action data for mifepristone
- Package insert warnings and contraindications from the Singapore regulator (HSA)
- Preclinical or early clinical evidence in ocular surface disease
- A route-of-administration assessment (the only Singapore product is an oral tablet, whereas an eye condition would likely need a topical or ocular formulation)
- A safety review of ocular use, including the corticosteroid interaction and the knowledge-graph contraindications
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.