ОБЗОР
МЕЖДУНАРОДНЫХ
ПЕРИОДИЧЕСКИХ
ИЗДАНИЙ

НОВОСТИ СВЕЖИЙ НОМЕР ОБ ИЗДАНИИ
Для специалистов по репродуктивному здоровью. PROdigest. Приложение к бюллетеню
prodigest prodigest prodigest prodigest prodigest
2015 vol1 2015 vol2 2015 vol3 2016 2017

Drospirenone-containing combined oral contraceptives and the risk of arterial thrombosis: a population-based nested case-control study

Authors: Larivée N, Suissa S, Eberg M, Joseph L, Eisenberg MJ, Abenhaim HA, Filion KB.
DOI: 10.1111/1471-0528.14358
Abstract

OBJECTIVE:
To compare the rate of arterial thromboembolism (ATE) of drospirenone-containing COCs to that of levonorgestrel-containing COCs.

DESIGN: Population-based cohort study.

SETTING:
United Kingdom’s Clinical Practice Research Datalink (CPRD), which contains clinical records for >11 million patients.

POPULATION:
Women aged 16-45 years prescribed a drospirenone- or levonorgestrel-containing COC between May 2002 and June 2012.

METHODS:
We conducted nested case-control analyses using risk set sampling to randomly select up to 10 controls for each ATE case, matched on age, cohort entry year, CPRD registration year, COC user type (first-time ever, new, switcher, or prevalent users), duration of COC use, duration of progestin-only or implantable contraceptive use, pre-cohort entry duration of drospirenone and levonorgestrel use, and duration of follow up.

MAIN OUTCOME MEASURES:
We used conditional logistic regression to estimate hazard ratios and 95% confidence intervals (CIs), adjusted for high-dimensional propensity scores.

RESULTS:
Our cohort included 339 743 women followed over a mean 4.4 years, during which 228 ATE cases occurred: 37 myocardial infarctions, 170 strokes, and 21 other ATEs; overall rate: 1.5 events per 10 000 person-years (PYs). After adjusting for potential confounders, the hazard ratio for ATE with current use of drospirenone-containing COCs versus current use of levonorgestrel-containing COCs was 0.89 (95% CI 0.35, 2.28), corresponding to a rate difference of -0.16 events per 10 000 PYs.

CONCLUSIONS:

The overall rate of ATE in this population is low regardless of which COC was taken. We found little evidence of a difference in the rate of ATE with drospirenone- versus levonorgestrel-containing COCs.

TWEETABLE ABSTRACT:
Little evidence was found of a greater incidence of arterial thrombosis with drospirenone versus levonorgestrel contraceptives.

© 2016 Royal College of Obstetricians and Gynaecologists.

KEYWORDS:
Arterial thromboembolism; drospirenone; drug safety; oral contraceptives

If you have found a spelling error, please, notify us by selecting that text and pressing Ctrl+Enter.