Key Takeaways
- •Shim, J. Y., Park, Y. W., Yoon, B. H., Cho, Y. K., Yang, J. H., Lee, Y. and Kim, A. (2006). 'Multicentre, parallel group, randomised, single-blind study of the safety and efficacy of atosiban versus ritodrine in the treatment of acute preterm labour in Korean women’, Bjog An International Journal of Obstetrics & Gynaecology, 113(11), 1228-1234.
- •Romero, R., Sibai, B. M., Sanchez, R. L., Valenzuela, G. J., Veille, J. C., Tabor, B., and Perry, K. G. (2000). 'An oxytocin receptor antagonist (atosiban) in the treatment of preterm labor: a randomized, double-blind, placebo-controlled trial with tocolytic rescue’, American Journal of Obstetrics & Gynecology, 182(5), 1173-1183.
- •Coomarasamy, A., Knox E. M., Gee, H., and Khan, K. S. (2002). 'Oxytocin antagonists for tocolysis in preterm labour-a systematic review’, Med Sci Monit, 8(11), 268-273.
- •Papatsonis, D., Flenady, V., Liley, H. (2009), 'Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after threatened preterm labour’, Cochrane Database Syst Rev, (1), CD005938.
- •De, H. R., Mol, B.W., Erwich, J. J., Geijnet, H. P., and Gyselaers, W. J. (2009), 'Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study’, BMJ, 5(3), 738-744.
Atosiban Targets Preterm Labor Risks
Preterm labor stands as a leading cause of neonatal issues and mortality around the world. Current treatments focus on tocolysis to delay birth, but agents like sympathomimetics only postpone delivery by up to 48 hours during acute episodes. Patients often face repeated preterm labor, hospital stays, repeat intravenous treatments, and early births, where atosiban steps in as a maintenance option.
Marketed in China in 2006, atosiban acts as an oxytocin-receptor antagonist. It helps prevent these ongoing complications after initial therapy.
How Atosiban Works
Atosiban binds competitively to oxytocin receptors located in the uterine decidual membrane and myometrium. This action blocks the rise in oxytocin receptor numbers, which in turn diminishes oxytocin's influence.
By lowering available receptors, atosiban reduces uterine contractions effectively. Researchers note this mechanism supports its use in maintenance therapy.
For peptide researchers, tools like the Peptide Glossary provide definitions of terms such as oxytocin antagonists.
Evidence from Key Trials
A multicenter, double-blind study by Romero involved 246 women in the atosiban group and 255 in the placebo control. Results showed higher rates of delaying delivery beyond 48 hours (67% versus 56%) and 7 days (62% versus 49%) with atosiban.
Shim et al. found atosiban outperformed litojun in efficacy and safety, with 59.7% versus 47.4% inhibition of uterine contractions compared to beta-2 receptor agonists.
Comparisons with Beta-2 Agonists
Coomarasamy's randomized, double-blind multicenter trial included 733 pregnant women from three countries. The atosiban group showed no significant differences from the beta-2 agonists group in births within 48 hours (88.1% versus 88.9%), within 7 days (79.7% versus 77.6%), gestational age at delivery (35.8 weeks versus 35.5 weeks), or neonatal birth weight (2491g versus 2461g).
However, atosiban caused far fewer adverse effects, particularly cardiovascular ones (8.3% versus 81.2%). Fewer participants stopped treatment due to side effects (1.1% versus 15.4%).
Safety Across Large Cohorts
Papatsonis et al. reported that atosiban versus placebo did not lower rates of birth before 37 weeks, 32 weeks, or 28 weeks of gestation. It also showed no reduction in perinatal mortality or neonatal morbidity.
In a prospective cohort by De et al., 1920 pregnant women from 28 hospitals in the Netherlands or Belgium participated. Atosiban demonstrated strong maternal and fetal safety, with only one of 575 women experiencing nausea (0.2% incidence).
Volta publishes free peptide tools for research planning, including calculators for reconstitution, molarity and storage.
Clinical Study References
- Shim, J. Y., Park, Y. W., Yoon, B. H., Cho, Y. K., Yang, J. H., Lee, Y. and Kim, A. (2006). 'Multicentre, parallel group, randomised, single-blind study of the safety and efficacy of atosiban versus ritodrine in the treatment of acute preterm labour in Korean women’, Bjog An International Journal of Obstetrics & Gynaecology, 113(11), 1228-1234.
- Romero, R., Sibai, B. M., Sanchez, R. L., Valenzuela, G. J., Veille, J. C., Tabor, B., and Perry, K. G. (2000). 'An oxytocin receptor antagonist (atosiban) in the treatment of preterm labor: a randomized, double-blind, placebo-controlled trial with tocolytic rescue’, American Journal of Obstetrics & Gynecology, 182(5), 1173-1183.
- Coomarasamy, A., Knox E. M., Gee, H., and Khan, K. S. (2002). 'Oxytocin antagonists for tocolysis in preterm labour-a systematic review’, Med Sci Monit, 8(11), 268-273.
- Papatsonis, D., Flenady, V., Liley, H. (2009), 'Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after threatened preterm labour’, Cochrane Database Syst Rev, (1), CD005938.
- De, H. R., Mol, B.W., Erwich, J. J., Geijnet, H. P., and Gyselaers, W. J. (2009), 'Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study’, BMJ, 5(3), 738-744.
