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Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor VLeiden mutation: a randomized trial.
Blood. 2004 Feb 01; 103(3):927-33.Blood

Abstract

A plausible mechanism to explain thrombotic risk differences associated with the use of second- and third-generation oral contraceptives (OCs), particularly in carriers of factor V(Leiden), is still lacking. In a double-blind trial, 51 women without and 35 women with factor V(Leiden) were randomized to either a second- (30 microg ethinylestradiol/150 microg levonorgestrel) or third- (30 microg ethinylestradiol/150 microg desogestrel) generation OC. After 2 cycles of use and a wash-out of 2 cycles, the participants continued with the corresponding progestagen-only preparation. Hemostatic variables that probe the activity of the anticoagulant protein C system were determined. Compared with levonorgestrel, desogestrel-containing OCs significantly decreased protein S and increased activated protein C (APC) resistance in both groups. OCs with desogestrel had the most pronounced effects in carriers of factor V(Leiden). Progestagen-only preparations caused changes of anticoagulant parameters opposite to those of combined OCs, which in a number of cases were more pronounced with levonorgestrel. Our data show that progestagens in combined OCs counteract the thrombotic effect of the estrogen component. The higher thrombotic risk associated with third-generation OCs compared with second-generation OCs may be explained by the fact that desogestrel appeared less antithrombotic than levonorgestrel, especially in women with factor V(Leiden).

Authors+Show Affiliations

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Room D.01.335, PO Box 85500, 3508 GA Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14551147

Citation

Kemmeren, Jeanet M., et al. "Effect of Second- and Third-generation Oral Contraceptives On the Protein C System in the Absence or Presence of the Factor VLeiden Mutation: a Randomized Trial." Blood, vol. 103, no. 3, 2004, pp. 927-33.
Kemmeren JM, Algra A, Meijers JC, et al. Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor VLeiden mutation: a randomized trial. Blood. 2004;103(3):927-33.
Kemmeren, J. M., Algra, A., Meijers, J. C., Tans, G., Bouma, B. N., Curvers, J., Rosing, J., & Grobbee, D. E. (2004). Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor VLeiden mutation: a randomized trial. Blood, 103(3), 927-33.
Kemmeren JM, et al. Effect of Second- and Third-generation Oral Contraceptives On the Protein C System in the Absence or Presence of the Factor VLeiden Mutation: a Randomized Trial. Blood. 2004 Feb 1;103(3):927-33. PubMed PMID: 14551147.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor VLeiden mutation: a randomized trial. AU - Kemmeren,Jeanet M, AU - Algra,Ale, AU - Meijers,Joost C M, AU - Tans,Guido, AU - Bouma,Bonno N, AU - Curvers,Joyce, AU - Rosing,Jan, AU - Grobbee,Diederick E, Y1 - 2003/10/09/ PY - 2003/10/11/pubmed PY - 2004/3/11/medline PY - 2003/10/11/entrez SP - 927 EP - 33 JF - Blood JO - Blood VL - 103 IS - 3 N2 - A plausible mechanism to explain thrombotic risk differences associated with the use of second- and third-generation oral contraceptives (OCs), particularly in carriers of factor V(Leiden), is still lacking. In a double-blind trial, 51 women without and 35 women with factor V(Leiden) were randomized to either a second- (30 microg ethinylestradiol/150 microg levonorgestrel) or third- (30 microg ethinylestradiol/150 microg desogestrel) generation OC. After 2 cycles of use and a wash-out of 2 cycles, the participants continued with the corresponding progestagen-only preparation. Hemostatic variables that probe the activity of the anticoagulant protein C system were determined. Compared with levonorgestrel, desogestrel-containing OCs significantly decreased protein S and increased activated protein C (APC) resistance in both groups. OCs with desogestrel had the most pronounced effects in carriers of factor V(Leiden). Progestagen-only preparations caused changes of anticoagulant parameters opposite to those of combined OCs, which in a number of cases were more pronounced with levonorgestrel. Our data show that progestagens in combined OCs counteract the thrombotic effect of the estrogen component. The higher thrombotic risk associated with third-generation OCs compared with second-generation OCs may be explained by the fact that desogestrel appeared less antithrombotic than levonorgestrel, especially in women with factor V(Leiden). SN - 0006-4971 UR - https://www.unboundmedicine.com/medline/citation/14551147/Effect_of_second__and_third_generation_oral_contraceptives_on_the_protein_C_system_in_the_absence_or_presence_of_the_factor_VLeiden_mutation:_a_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-4971(20)50226-7 DB - PRIME DP - Unbound Medicine ER -