Combination OCs and VTE Risk: Nailing Down the Role of the Progestin

Clinicians should prescribe combination OCs containing progestins with the lowest excess risk for VTE.

Combination estrogen-progestin oral contraceptives (OCs) are associated with excess risk for venous thromboembolism (VTE), but controversy persists about the relative contributions of specific progestins. These relations were analyzed using two general practice databases in the U.K. This study, the largest to date, included 10,562 VTE cases and 42,034 age-matched women without VTE. Odds ratios (ORs) were adjusted for smoking status, alcohol use, ethnic group, body-mass index, and comorbidities.

Current use of combination OCs was associated with increased risk for VTE (overall OR, 2.97; 95% confidence interval (CI), 2.78–3.17), and progestin type influenced degree of risk. The three progestins that raised VTE risk the least were:

Levonorgestre…

Reviewing Author

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Combination OCs and VTE Risk: Nailing Down the Role of the Progestin

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Reviewing Author