Abstract | OBJECTIVE: SUBJECTS AND METHODS: All premenopausal women with first incident VTE who were referred to our unit (Paris, France) between 2000 and 2009 were included in this case-only study. Differences in interactions by progestin type were assessed on a multiplicative scale, assuming the independence of genotype and prescription of type of CHC. RESULTS: Among 2,613 women with VTE, 15.9% had a FVL and 69% used CHC. The interaction between CHC use and presence of FVL on VTE risk was statistically significant (1.37, 1.06-1.77 95% confidence interval [CI]). This interaction appeared higher for drospirenone 1.99 (1.18-3.38 95% CI) (n = 98) or cyproterone acetate users 1.71 (1.20-2.45 95% CI) (n = 326), but not significant for 1st or 2nd or norgestimate CHC users. The results were similar when excluding women with a family history of VTE or with provoked VTE. In this sub-group of women, these interactions appeared higher for third generation, cyproterone acetate and drospirenone CHC users as compared with 1st or 2nd or norgestimate CHC users (odds ratio [OR], 1.68 [1.04-2.70; 95% CI], 2.91 [1.71-4.95 95% CI], 3.22 [1.54-6.73 95% CI], respectively). CONCLUSION: Our results show that the interaction between FVL and CHC use differ by progestin type, which is higher in CHC containing third-generation progestin, drospirenone or cyproterone acetate, compared with second generation. Further studies are needed to assess the cost-effectiveness of biological thrombophilia screening (FVL) when such prescription of CHC is planned.
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Authors | Justine Hugon-Rodin, Marie-Hélène Horellou, Jacqueline Conard, Anne Gompel, Geneviève Plu-Bureau |
Journal | Thrombosis and haemostasis
(Thromb Haemost)
Vol. 118
Issue 5
Pg. 922-928
(05 2018)
ISSN: 2567-689X [Electronic] Germany |
PMID | 29614525
(Publication Type: Comparative Study, Journal Article)
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Copyright | Schattauer GmbH Stuttgart. |
Chemical References |
- Androstenes
- Contraceptives, Oral, Combined
- Contraceptives, Oral, Hormonal
- Progestins
- factor V Leiden
- Cyproterone Acetate
- Factor V
- drospirenone
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Topics |
- Adolescent
- Adult
- Androstenes
(adverse effects)
- Blood Coagulation Disorders, Inherited
(blood, diagnosis, epidemiology, genetics)
- Contraceptives, Oral, Combined
(adverse effects)
- Contraceptives, Oral, Hormonal
(adverse effects)
- Cyproterone Acetate
(adverse effects)
- Factor V
(genetics)
- Female
- Humans
- Incidence
- Middle Aged
- Paris
(epidemiology)
- Premenopause
(blood)
- Progestins
(adverse effects)
- Risk Factors
- Venous Thromboembolism
(chemically induced, diagnosis, epidemiology, genetics)
- Young Adult
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