Comparison of Thromboembolism Outcomes in Patients with Sickle Cell Disease Prescribed Hormonal Contraception

This study aims to assess patterns of hormonal contraceptive use and compare risk of contraception-related TE between combined hormonal contraceptives (CHC) and progestin-only contraceptives (POC). Patients with SCD between 12-44 years with a new prescription of a hormonal contraceptive in the CMS MAX database (2006-2018) were followed for one year. Cox regression analysis was used to calculate the hazard ratio (HR) of TE. We identified 7,173 new users: 44.6% initiated CHC and 55.4% initiated POC. Combined oral contraceptive pills (OCP) (36.5%) and progestin-only depot medroxyprogesterone acetate (33.9%) were the most frequently prescribed agents. A total of 1.8% of contraception users had a new diagnosis of TE within one year of first identified contraception prescription. There were no significant differences in TE event rates between CHC and POC users (17.2 and 24.7 events per 1000 person-years respectively, adjusted HR=0.83, 95% CI: 0.58-1.21; p-value=0.336). In patients prescribed OCP, there were no differences in TE event rates based on estrogen dose or progestin generation. Transdermal patch had 2.4 fold increased risk of TE as compared to OCP. Although limited by the retrospective study design and use of administrative claims data, this study found no significant differences in TE rates between new users of CHC and POC in patients with SCD. Careful evaluation of underlying TE risk factors should be considered in each patient with SCD prior to initiation of hormonal co...
Source: Adv Data - Category: Epidemiology Authors: Source Type: research