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Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch.
Contraception. 2006 Oct; 74(4):290-2.C

Abstract

BACKGROUND

It has been suggested that the risk for cerebral venous sinus thrombosis (CVST) may be greater among users of the contraceptive patch than among users of oral contraceptives (OCs).

METHODS

From the PharMetrics database, we identified women aged 15-44 years who filled at least one prescription for either the contraceptive patch or desogestrel-containing, norgestimate-containing or levonorgestrel-containing OCs to assess the risk of CVST. The person-time of current exposure to each study drug, as well as the incidence rates (IRs) and incidence rate ratios (IRRs) of CVST, was calculated.

RESULTS

We identified over 1 million users of the four study drugs. There were five cases of CVST among current users of desogestrel, seven cases among current users of norgestimate, two cases among current users of levonorgestrel and none among current users of the contraceptive patch. The IRs per 100,000 woman-years were 2.7 [95% confidence interval (95% CI)=0.9-6.3], 1.6 (95% CI=0.7-3.3), 0.7 (95% CI=0.1-2.4) and 0.0 (95% CI=0.0-4.8), respectively, in users of desogestrel, norgestimate, levonorgestrel and the contraceptive patch. There were two women who had CVST while not currently taking a hormonal contraceptive (IR=0.4 per 100,000 woman-years; 95% CI=0.1-1.3). The IRRs were 4.0 (95% CI=0.7-42.4) for desogestrel-containing versus levonorgestrel-containing OCs, and 2.4 (95% CI=0.5-24.0) for norgestimate-containing versus levonorgestrel-containing OCs. The IRR for the patch could not be calculated.

CONCLUSIONS

There is no evidence of an increased risk of CVST in users of the contraceptive patch compared to users of levonorgestrel-containing OCs.

Authors+Show Affiliations

Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, MA 02421, USA. sjick@bu.edu <sjick@bu.edu>No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16982227

Citation

Jick, Susan S., and Hershel Jick. "Cerebral Venous Sinus Thrombosis in Users of Four Hormonal Contraceptives: Levonorgestrel-containing Oral Contraceptives, Norgestimate-containing Oral Contraceptives, Desogestrel-containing Oral Contraceptives and the Contraceptive Patch." Contraception, vol. 74, no. 4, 2006, pp. 290-2.
Jick SS, Jick H. Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch. Contraception. 2006;74(4):290-2.
Jick, S. S., & Jick, H. (2006). Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch. Contraception, 74(4), 290-2.
Jick SS, Jick H. Cerebral Venous Sinus Thrombosis in Users of Four Hormonal Contraceptives: Levonorgestrel-containing Oral Contraceptives, Norgestimate-containing Oral Contraceptives, Desogestrel-containing Oral Contraceptives and the Contraceptive Patch. Contraception. 2006;74(4):290-2. PubMed PMID: 16982227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch. AU - Jick,Susan S, AU - Jick,Hershel, Y1 - 2006/07/07/ PY - 2006/04/11/received PY - 2006/05/08/revised PY - 2006/05/10/accepted PY - 2006/9/20/pubmed PY - 2007/2/8/medline PY - 2006/9/20/entrez SP - 290 EP - 2 JF - Contraception JO - Contraception VL - 74 IS - 4 N2 - BACKGROUND: It has been suggested that the risk for cerebral venous sinus thrombosis (CVST) may be greater among users of the contraceptive patch than among users of oral contraceptives (OCs). METHODS: From the PharMetrics database, we identified women aged 15-44 years who filled at least one prescription for either the contraceptive patch or desogestrel-containing, norgestimate-containing or levonorgestrel-containing OCs to assess the risk of CVST. The person-time of current exposure to each study drug, as well as the incidence rates (IRs) and incidence rate ratios (IRRs) of CVST, was calculated. RESULTS: We identified over 1 million users of the four study drugs. There were five cases of CVST among current users of desogestrel, seven cases among current users of norgestimate, two cases among current users of levonorgestrel and none among current users of the contraceptive patch. The IRs per 100,000 woman-years were 2.7 [95% confidence interval (95% CI)=0.9-6.3], 1.6 (95% CI=0.7-3.3), 0.7 (95% CI=0.1-2.4) and 0.0 (95% CI=0.0-4.8), respectively, in users of desogestrel, norgestimate, levonorgestrel and the contraceptive patch. There were two women who had CVST while not currently taking a hormonal contraceptive (IR=0.4 per 100,000 woman-years; 95% CI=0.1-1.3). The IRRs were 4.0 (95% CI=0.7-42.4) for desogestrel-containing versus levonorgestrel-containing OCs, and 2.4 (95% CI=0.5-24.0) for norgestimate-containing versus levonorgestrel-containing OCs. The IRR for the patch could not be calculated. CONCLUSIONS: There is no evidence of an increased risk of CVST in users of the contraceptive patch compared to users of levonorgestrel-containing OCs. SN - 0010-7824 UR - https://www.unboundmedicine.com/medline/citation/16982227/Cerebral_venous_sinus_thrombosis_in_users_of_four_hormonal_contraceptives:_levonorgestrel_containing_oral_contraceptives_norgestimate_containing_oral_contraceptives_desogestrel_containing_oral_contraceptives_and_the_contraceptive_patch_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-7824(06)00254-X DB - PRIME DP - Unbound Medicine ER -