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BJOG. 2013 Jun;120(7):801-10. doi: 10.1111/1471-0528.12210. Epub 2013 Mar 26.

Drospirenone-containing oral contraceptive pills and the risk of venous and arterial thrombosis: a systematic review.

Author information

1
Faculty of Medicine, McGill University, Montreal, QC, Canada.

Abstract

BACKGROUND:

Previous studies have provided conflicting results regarding the effect of drospirenone-containing oral contraceptive pills (OCPs) on the risk of venous and arterial thrombosis.

OBJECTIVES:

To conduct a systematic review to assess the risk of venous thromboembolism (VTE), myocardial infarction (MI), and stroke in individuals taking drospirenone-containing OCPs.

SEARCH STRATEGY:

We systematically searched CINAHL, the Cochrane Library, Dissertation & Abstracts, EMBASE, HealthStar, Medline, and the Science Citation Index from inception to November 2012.

SELECTION CRITERIA:

We included all case reports, observational studies, and experimental studies assessing the risk of venous and arterial thrombosis of drospirenone-containing OCPs.

DATA COLLECTION AND ANALYSIS:

Data were collected independently by two reviewers.

MAIN RESULTS:

A total of 22 studies [six case reports, three case series (including 26 cases), and 13 comparative studies] were included in our systematic review. The 32 identified cases suggest a possible link between drospirenone-containing OCPs and venous and arterial thrombosis. Incidence rates of VTE among drospirenone-containing OCP users ranged from 23.0 to 136.7 per 100 000 woman-years, whereas those among levonorgestrel-containing OCP users ranged from 6.64 to 92.1 per 100 000 woman-years. The rate ratio for VTE among drospirenone-containing OCP users ranged from 4.0 to 6.3 compared with non-users of OCPs, and from 1.0 to 3.3 compared with levonorgestrel-containing OCP users. The arterial effects of drospirenone-containing OCPs were inconclusive.

AUTHOR'S CONCLUSIONS:

Our systematic review suggests that drospirenone-containing OCP use is associated with a higher risk for VTE than both no OCP use and levonorgestrel-containing OCP use.

PMID:
23530659
DOI:
10.1111/1471-0528.12210
[Indexed for MEDLINE]
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