Newer OCPs Associated with an Increase Risk of DVTs Part 2

Hot on the heels of a study published last week in the BMJ about an increase risk of blood clots resulting from newer forms of oral contraceptives, I serendipitously stumbled upon the early release of a study with a similar conclusion in yesterday's CMAJ (Canadian Medical Association Journal).

The authors followed a cohort of 329,995 Israeli women 12-50yo who had a filled at least one prescription for an oral contraceptive over a 6yr period of time.  Each type of hormonal contraception was considered a discrete episode and compared for risk of deep vein thrombosis (DVT), pulmonary embolism (PE), transient ischemic attack (TIA), and cerebrovascular accident (CVA) over an additional 3yr period of time.

Thromboembolic risk has been noted to return to baseline approximately 3mo after cessation of oral contraceptive use.  Therefore, any event that occurred more than 6mo after the last dispense date of an oral contraceptive was not deemed due to said contraceptive.

Despite taking into account the usual confounders such as diabetes, dyslipidemia, hypertension, cancer, smoking & obesity, the authors found that drospirenone-containing oral contraceptives were associated with an increase risk of venous thrombotic events, eg DVT & PE, but not arterial ones, eg TIA & CVA, compared to other oral contraceptives.

Let it be known that my goal is not to incite panic but rather to provoke a healthy discussion between the patient and her physician regarding the relative vs absolute risks of various contraceptive methods.  Without knowing the whole story, at least as much as we can understand, the patient isn't able to make an informed decision.  Here's to transparency & readily available medical information.

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