Research and practice in thrombosis and haemostasis · 2024
Incidence rate of venous thrombosis in women switching combined oral contraceptives: a cohort study.
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Khialani Deeksha, de Rooij Esther, Szépligeti Szimonetta Komjáthiné, Dudukina Elena, le Cessie Saskia, Ehrenstein Vera, Rosendaal Frits R, van Hylckama Vlieg Astrid
Аннотация
BACKGROUND: The incidence rate of venous thrombosis (VT) in women switching combined oral contraceptives (COCs) is unknown.
OBJECTIVES: We hypothesize that women switching COCs may have a similar increased incidence rate of VT as women who start COCs. Switching means starting with a new COC, which may biologically approximate starting.
METHODS: We conducted a cohort study with data from the Netherlands and Denmark. First, we identified starters who were defined as women who did not use COCs in the 2 years prior to the start of their first COC prescription within the study period. Switchers were a subset of COC starters who redeemed a COC formulation different from their initial COC during follow-up but not longer than 12 months after starting. We estimated incidence rate ratios (adjusted incidence rate ratio [aIRR]) of VT with 95% CIs among COC switchers as compared with COC starters using Poisson regression adjusted for age, COC progestogen generation, and preexisting obesity.
RESULTS: In both countries, we found an increased risk of VT among switchers as compared with starters during the first 3 months of the follow-up (aIRR = 1.77; 95% CI, 1.22-2.56 in the Netherlands and aIRR = 1.50; 95% CI, 1.04-2.16 in Denmark).
CONCLUSION: Switchers, particularly in the first 3 months after switching, may experience a renewed starter effect thereby increasing the risk of VT.
OBJECTIVES: We hypothesize that women switching COCs may have a similar increased incidence rate of VT as women who start COCs. Switching means starting with a new COC, which may biologically approximate starting.
METHODS: We conducted a cohort study with data from the Netherlands and Denmark. First, we identified starters who were defined as women who did not use COCs in the 2 years prior to the start of their first COC prescription within the study period. Switchers were a subset of COC starters who redeemed a COC formulation different from their initial COC during follow-up but not longer than 12 months after starting. We estimated incidence rate ratios (adjusted incidence rate ratio [aIRR]) of VT with 95% CIs among COC switchers as compared with COC starters using Poisson regression adjusted for age, COC progestogen generation, and preexisting obesity.
RESULTS: In both countries, we found an increased risk of VT among switchers as compared with starters during the first 3 months of the follow-up (aIRR = 1.77; 95% CI, 1.22-2.56 in the Netherlands and aIRR = 1.50; 95% CI, 1.04-2.16 in Denmark).
CONCLUSION: Switchers, particularly in the first 3 months after switching, may experience a renewed starter effect thereby increasing the risk of VT.