Comparing efficacy of vaginal misoprostol administered at 6-8 hours with 24 hours administration after 200 mg of oral mifepristone for early medical abortions

ISRCTN ISRCTN97410750
DOI https://doi.org/10.1186/ISRCTN97410750
EudraCT/CTIS number 2009-010277-21
Secondary identifying numbers TIMES/09-012/11
Submission date
18/02/2009
Registration date
06/03/2009
Last edited
25/05/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims:
An abortion is the deliberate termination of a pregnancy, most often performed during the first 28 weeks of pregnancy. In May 2010, the Department of Health released the latest abortion statistics. Total number of abortions in England and Wales were 189,100 in 2009, compared with 195,296 in 2008, a fall of 3.2%. Abortion rate was highest in women aged 19-21, whilst rates under-16 and under-18 were lower. 91% of abortions were carried out in women up to 13 weeks pregnant and 75% up to 10 weeks. Medical abortions accounted for 40% of the total. It is clear from this data that abortion treatments continue to be provided on a large scale. Newer methods are continuing to be developed to provide women with safe and effective methods. Interestingly not all methods are acceptable to all women and therefore the question of patients’ preferences and acceptance poses a clinical dilemma. The few studies that explored shorter time intervals show conflicting evidence have resulted in a large variation in clinical practice for administration of medications at different time intervals for medical abortions. The aim of this study is to assess the acceptability and success of shorter time interval treatments compared to standard time intervals treatments as well as exploring women’s perceptions and views through interviews.

Who can participate?
Adult women who are requesting an abortion

What does the study involve?
Participants are randomly allocated to one of two groups. Those in the first group receive the standard treatment regimen, involving misoprostol (a medication used to start labour) being given vaginally 24 hours after being given mifepristone (a medication used to bring about abortion). Those in the second group receive the same treatment but with a 6-8 hour window instead of 24 hours. Participants in both groups are followed up for two weeks to find out how acceptable the treatment they receive is.

What are the possible benefits and risks of participating?
There are no direct benefits or risks involved with participating.

Where is the study run from?
Calthorpe Clinic (UK)

When is study starting and how long is it expected to run for?
April 2009 to June 2011

Who is funding the study?
Calthorpe Clinic (UK)

Who is the main contact?
Professor Janesh Kumar Gupta
j.k.gupta@bham.ac.uk

Contact information

Prof Janesh Kumar Gupta
Scientific

Birmingham Women's Hospital
Second Floor
Academic Department
Metchely Park Road
Edgbaston
Birmingham
B15 2TG
United Kingdom

Phone +44 (0)121 607 4751
Email j.k.gupta@bham.ac.uk

Study information

Study designNon-inferiority randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleA randomised controlled trial on Efficacy of mifepristone followed by 6-8 hours versus 24 hours vaginal misoprostol in Early Medical Abortions (< 63 days gestation)
Study acronymTIMES Study (Time Interval for Medical Early abortionS)
Study objectivesThe hypothesis for this study is to determine the efficacy of shorter time intervals of administration of misoprostol and also to assess the reliability of follow-up methods to confirm completeness of medical abortion. To explore women’s beliefs and preferences to different medical methods within the framework of the randomised controlled trial.
Ethics approval(s)Research Ethics Committee and South Birmingham PCT, 22/06/2009, ref: 09/H1208/22
Health condition(s) or problem(s) studiedEarly medical abortion
InterventionParticipants are randomised to one of two groups using computerised randomisation

Control group: Participants receive the standard treatment regimen of 800mcg of misoprostol as vaginal route 24 hours following administration of 200mg of mifepristone

Intervention group: Participants receive 800 ug of misoprostol given vaginally after 200 mg of mifepristone at 6-8 hours interval or 24 hours interval.

All women will be followed up to a period of 2 weeks.
Intervention typeOther
Primary outcome measureProportion of complete abortions where no further medical or surgical intervention beyond the initial dose of vaginal misoprostol required was measured using patient acceptability questionnaire and ultrasound confirmation at the end of 2 weeks.
Secondary outcome measures1. Induction to abortion interval is measured using based on the duration of pain and bleeding at 2 weeks follow up
2. Adverse effects is measured using Likert scale at 2 weeks follow up
3. Pain is measured using VAS at 2 weeks follow up
4. Duration of Bleeding is measured using the No.of hours or days at 2 weeks follow up
5. Acceptability of women towards the new regimen is measured using Likert scale at the 2 weeks follow up
6. Assess reliability of follow-up methods following medical abortion is measured using telephone follow up at 1 week and Urinary quantification of hCG at baseline.2 weeks

For the purpose of qualitative study face to face in depth interviews were conducted at the end of 2 weeks
Overall study start date01/04/2009
Completion date01/06/2011

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants1,200
Key inclusion criteria1. Ability to give informed written consent
2. Women who are 18 years and older
3. Requesting abortion and eligible for legal termination of pregnancy
4. Duration of pregnancy not more than 63 days (counted from the first day of the last menstrual period) in a normal 28-day cycle or verified by ultrasound
5. The pregnancy is single and intrauterine (single sac)
6. Agree to be able to be contacted by telephone (i.e. mobile telephone)
7. Women with limited understanding of English will be included only in the quantitative study where interpreters are available
Key exclusion criteria1. Any indication of serious past or present ill health will be considered a contraindication for recruitment to the study
2. Suspicion of any pathology of pregnancy (e.g. molar, non-viable pregnancy, threatened abortion)
3. Current participation in a drug-related trial
4. Non-English-speaking women for the qualitative study
5. Women under the age of 18 years
Date of first enrolment15/09/2009
Date of final enrolment15/12/2010

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Calthorpe Clinic
4 Arthur Road
Edgbaston
Birmingham
B15 2UL
United Kingdom

Sponsor information

Calthorpe Clinic (UK)
Hospital/treatment centre

c/o Carolyn Philips
4 Arthur Road
Edgbaston
Birmingham
B15 2UL
England
United Kingdom

Website http://www.calthorpe-clinic.co.uk/
ROR logo "ROR" https://ror.org/007bv1h22

Funders

Funder type

Hospital/treatment centre

Calthorpe Clinic (UK)

No information available

Results and Publications

Intention to publish date31/12/2017
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryStored in repository
Publication and dissemination planIntend to plan publication in peer reviewed journal, currently available as part of MD Thesis repository electronically from the University of Birmingham.
IPD sharing planThe datasets generated during and/or analysed during the current study will be stored in a non-publically available repository - University of Birmingham thesis repository library =

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
HRA research summary 28/06/2023 No No

Editorial Notes

25/05/2017: The timepoints and methods of measurement have been added to the outcome measures and the plain English summary has been added.
09/05/2017: The overall trial dates have been updated from 01/06/2009 - 01/06/2011 to 01/04/2009 - 01/06/2011 and the recruitment dates have been updated from 01/06/2009 - 01/06/2011 to 15/09/2009 - 15/12/2010. In addition, the ethics approval information, interventions, EudraCT number, publication and dissemination plan and IPD sharing statement have been added.
13/04/2017: No publications found in PubMed, verifying study status with principal investigator