Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis

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Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis

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Title: Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis
Author: Mantha, S; Raghavan, V; Terrin, N; Karp, Rebecca Sara; Bauer, Kenneth Alan; Zwicker, Jeffrey Isaac

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Citation: Mantha, S, R Karp, V Raghavan, N Terrin, K A Bauer, and J I Zwicker. 2012. Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis. British Medical Journal 345:e4944.
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Abstract: Objectives: To evaluate the risk of venous thromboembolic events associated with the use of progestin-only contraception and whether that risk differs with the mode of drug delivery (oral, intrauterine, or depot injection). Design: Systematic review and meta-analysis of randomised controlled trials and observational studies. Data sources: Pubmed, Embase, Cochrane Library, and reference lists of relevant reviews. Study selection: Randomised controlled trials and case-control, cohort, and cross sectional studies with venous thromboembolic outcome for progestin-only contraception reported relative to a non-hormone comparator group. Data extraction: Data were extracted by two independent investigators, and consensus for inclusion was reached after assessment by additional investigators. Results: Among the 2022 unique references identified by all searches, eight observational studies fulfilled inclusion criteria. A total of 147 women across all studies were diagnosed with a venous thromboembolic event while taking progestin-only contraception, and the summary measure for the adjusted relative risk of a venous thromboembolic episode for users versus non-users of a progestin-only contraceptive was, based on the random effects model, 1.03 (95% CI 0.76 to 1.39). Subgroup analysis confirmed there was no association between venous thromboembolic risk and progestin-only pills (relative risk 0.90 (0.57 to 1.45)) or a progestin intrauterine device (0.61 (0.24 to 1.53)). The relative risk of a venous thromboembolic event for users of an injectable progestin versus non-users was 2.67 (1.29 to 5.53). Conclusions: Published data assessing the risk of venous thromboembolism in women prescribed progestin-only contraception are limited. In this meta-analysis of eight observational studies, the use of progestin-only contraception was not associated with an increased risk of venous thromboembolism compared with non-users of hormonal contraception. The potential association between injectable progestins and thrombosis requires further study.
Published Version: doi:10.1136/bmj.e4944
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413580/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:10466005
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