Tags

Type your tag names separated by a space and hit enter

Etonogestrel concentrations among contraceptive implant users in Botswana using and not using dolutegravir-based antiretroviral therapy.
Contraception. 2020 May 07 [Online ahead of print]C

Abstract

OBJECTIVES

To evaluate whether etonogestrel concentrations are reduced to a level that could potentially reduce contraceptive efficacy when the etonogestrel contraceptive implant is used concomitantly with dolutegravir-based antiretroviral therapy (ART).

STUDY DESIGN

We conducted a non-randomized, open-label, cross-sectional pharmacokinetic study among women using single-rod etonogestrel contraceptive implants in Botswana. We compared plasma etonogestrel concentrations, sampled at a single time-point between 3 and 12 months from implant insertion, among implant users living with HIV and receiving dolutegravir-based ART with HIV-negative implant users. We also assessed concentrations among implant users living with HIV and receiving efavirenz-based ART. We compared geometric mean etonogestrel concentrations analyzing data from 142 participants: 97 HIV-negative, 30 using dolutegravir, and 15 using efavirenz.

RESULTS

The groups were similar. Duration of implant use was between 3 and 12 months (median = 5). Geometric mean etonogestrel plasma concentrations and 90% confidence intervals of the mean were 227.5(212.4-243.8), 289.6(251.8-333.0) and 76.4(63.9-91.4) pg/mL among the HIV-negative, dolutegravir- and efavirenz-based ART groups, respectively. All women in the HIV-negative and dolutegravir-based ART groups had etonogestrel concentrations above 90 pg/mL; 9/15 women (60%) using efavirenz-based ART had concentrations below 90 pg/mL. On average, etonogestrel levels were lower among individuals who had implants inserted for longer durations.

CONCLUSIONS

Implant users receiving dolutegravir-based ART had a higher mean etonogestrel concentration compared to HIV-negative women, and none had etonogestrel concentrations below the posited threshold for ovulation suppression. In contrast, women in the efavirenz-group had much lower etonogestrel concentrations. Overall, these data provide evidence that the etonogestrel implant may be effectively combined with dolutegravir-based ART regimens.

IMPLICATIONS

The etonogestrel implant remains a highly effective contraceptive option for women living with HIV who use dolutegravir-based ART.

Authors+Show Affiliations

Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, United States.Botswana-University of Pennsylvania Partnership, University of Botswana Main Campus 244G - Room 103, Gaborone, Botswana; Botswana Harvard Partnership, Private Bag BO 320, Gaborone, Botswana.Botswana Harvard Partnership, Private Bag BO 320, Gaborone, Botswana.Botswana-University of Pennsylvania Partnership, University of Botswana Main Campus 244G - Room 103, Gaborone, Botswana.Botswana-University of Pennsylvania Partnership, University of Botswana Main Campus 244G - Room 103, Gaborone, Botswana.Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, United States.Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, United States.Botswana Harvard Partnership, Private Bag BO 320, Gaborone, Botswana.Botswana Harvard Partnership, Private Bag BO 320, Gaborone, Botswana.Botswana Ministry of Health and Wellness, Nelson Mandela Drive, Gaborone, Botswana.Botswana Ministry of Health and Wellness, Nelson Mandela Drive, Gaborone, Botswana; Afya Bora Consortium Fellowship Program, Botswana.Botswana Ministry of Health and Wellness, Nelson Mandela Drive, Gaborone, Botswana.Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, United States.Botswana-University of Pennsylvania Partnership, University of Botswana Main Campus 244G - Room 103, Gaborone, Botswana; Botswana Harvard Partnership, Private Bag BO 320, Gaborone, Botswana; Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool L3 5QA, United Kingdom. Electronic address: chelsea.morroni@lstmed.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32387328

Citation

Bishop, Ian J., et al. "Etonogestrel Concentrations Among Contraceptive Implant Users in Botswana Using and Not Using Dolutegravir-based Antiretroviral Therapy." Contraception, 2020.
Bishop IJ, Gertz AM, Simon B, et al. Etonogestrel concentrations among contraceptive implant users in Botswana using and not using dolutegravir-based antiretroviral therapy. Contraception. 2020.
Bishop, I. J., Gertz, A. M., Simon, B., Tawe, L., Lechiile, K., Liu, S., Teodoro, N., Mussa, A., Avalos, A., Malima, S., Maotwe, T., Mokganya, L., Westhoff, C. L., & Morroni, C. (2020). Etonogestrel concentrations among contraceptive implant users in Botswana using and not using dolutegravir-based antiretroviral therapy. Contraception. https://doi.org/10.1016/j.contraception.2020.04.019
Bishop IJ, et al. Etonogestrel Concentrations Among Contraceptive Implant Users in Botswana Using and Not Using Dolutegravir-based Antiretroviral Therapy. Contraception. 2020 May 7; PubMed PMID: 32387328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Etonogestrel concentrations among contraceptive implant users in Botswana using and not using dolutegravir-based antiretroviral therapy. AU - Bishop,Ian J, AU - Gertz,Alida M, AU - Simon,Boikhutso, AU - Tawe,Leabaneng, AU - Lechiile,Kwana, AU - Liu,Serena, AU - Teodoro,Nicholas, AU - Mussa,Aamirah, AU - Avalos,Ava, AU - Malima,Sifelani, AU - Maotwe,Tshego, AU - Mokganya,Lesego, AU - Westhoff,Carolyn L, AU - Morroni,Chelsea, Y1 - 2020/05/07/ PY - 2020/03/31/received PY - 2020/04/27/revised PY - 2020/04/28/accepted PY - 2020/5/11/pubmed PY - 2020/5/11/medline PY - 2020/5/11/entrez KW - Antiretroviral therapy KW - Contraceptive implant KW - Dolutegravir KW - Drug–drug interaction KW - Efavirenz KW - Etonogestrel JF - Contraception JO - Contraception N2 - OBJECTIVES: To evaluate whether etonogestrel concentrations are reduced to a level that could potentially reduce contraceptive efficacy when the etonogestrel contraceptive implant is used concomitantly with dolutegravir-based antiretroviral therapy (ART). STUDY DESIGN: We conducted a non-randomized, open-label, cross-sectional pharmacokinetic study among women using single-rod etonogestrel contraceptive implants in Botswana. We compared plasma etonogestrel concentrations, sampled at a single time-point between 3 and 12 months from implant insertion, among implant users living with HIV and receiving dolutegravir-based ART with HIV-negative implant users. We also assessed concentrations among implant users living with HIV and receiving efavirenz-based ART. We compared geometric mean etonogestrel concentrations analyzing data from 142 participants: 97 HIV-negative, 30 using dolutegravir, and 15 using efavirenz. RESULTS: The groups were similar. Duration of implant use was between 3 and 12 months (median = 5). Geometric mean etonogestrel plasma concentrations and 90% confidence intervals of the mean were 227.5(212.4-243.8), 289.6(251.8-333.0) and 76.4(63.9-91.4) pg/mL among the HIV-negative, dolutegravir- and efavirenz-based ART groups, respectively. All women in the HIV-negative and dolutegravir-based ART groups had etonogestrel concentrations above 90 pg/mL; 9/15 women (60%) using efavirenz-based ART had concentrations below 90 pg/mL. On average, etonogestrel levels were lower among individuals who had implants inserted for longer durations. CONCLUSIONS: Implant users receiving dolutegravir-based ART had a higher mean etonogestrel concentration compared to HIV-negative women, and none had etonogestrel concentrations below the posited threshold for ovulation suppression. In contrast, women in the efavirenz-group had much lower etonogestrel concentrations. Overall, these data provide evidence that the etonogestrel implant may be effectively combined with dolutegravir-based ART regimens. IMPLICATIONS: The etonogestrel implant remains a highly effective contraceptive option for women living with HIV who use dolutegravir-based ART. SN - 1879-0518 UR - https://www.unboundmedicine.com/medline/citation/32387328/Etonogestrel_concentrations_among_contraceptive_implant_users_in_Botswana_using_and_not_using_dolutegravir-based_antiretroviral_therapy L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-7824(20)30134-7 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.