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

BackgroundPrevious studies have provided conflicting results regarding the effect of drospirenone‐containing oral contraceptive pills (OCPs) on the risk of venous and arterial thrombosis. ObjectivesTo conduct a systematic review to assess the risk of venous thromboembolism (VTE), myocardial infarction (MI), and stroke in individuals taking drospirenone‐containing OCPs. Search strategyWe systematically searched CINAHL, the Cochrane Library, Dissertation & Abstracts, EMBASE, HealthStar, Medline, and the Science Citation Index from inception to November 2012. Selection criteriaWe included all case reports, observational studies, and experimental studies assessing the risk of venous and arterial thrombosis of drospirenone‐containing OCPs. Data collection and analysisData were collected independently by two reviewers. Main resultsA 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...
Source: BJOG: An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: Systematic Review Source Type: research