ArticleBMJ (Clinical research ed.)2011
Risk of venous thromboembolism in users of oral contraceptives containing drospirenone or levonorgestrel: nested case-control study based on UK General Practice Research Database.
Article in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 5 of them syntheses that pooled it.
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Who cites it
48 citing papers in PubMed, 5 syntheses or guidelines pooled it, 202 citations in OpenAlex.
- A systematic review and meta-analysis of venous thrombosis risk among users of combined oral contraception.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2018Pooled it
- Is real world evidence influencing practice? A systematic review of CPRD research in NICE guidances.BMC health services research · 2016Pooled it
- Combined oral contraceptives: venous thrombosis.The Cochrane database of systematic reviews · 2014Pooled it
- Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2013Pooled it
- Oral contraceptives and venous thromboembolism: a systematic review and meta-analysis.Drug safety · 2012Pooled it
- Long-term tolerability of ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen: results from a randomised, controlled, multicentre study.The journal of family planning and reproductive health care · 2012Trial
- The violence of reproductive injustice: Reflections on birth control and its medical epistemics.International journal for equity in health · 2025Article
- GnRH analogs as a monotherapy in transgender and gender-diverse adolescents: clinical insights from a single-center study.Endocrine connections · 2025Article
- High risk oral contraceptive hormones do not directly enhance endothelial cell procoagulant activity in vitro.PloS one · 2023Article
- Thromboembolic safety of norethisterone vs levonorgestrel in combined oral contraceptive users: a pooled analysis of 4 large prospective cohort studies.AJOG global reports · 2022Article
- Venous thromboembolism associated with combined oral contraceptive use: a single-institution experience.Obstetrics & gynecology science · 2021Article
- The Risk of Venous Thromboembolism (VTE) in Men with Benign Prostatic Hyperplasia Treated with 5-Alpha Reductase Inhibitors (5ARIs).Clinical epidemiology · 2021Article
- Do Norwegian providers comply with national recommendations when prescribing combined oral contraceptives to starters? A cohort study.BMJ open · 2019Article
- Association of Risk for Venous Thromboembolism With Use of Low-Dose Extended- and Continuous-Cycle Combined Oral Contraceptives: A Safety Study Using the Sentinel Distributed Database.JAMA internal medicine · 2018Article
- The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases.Intestinal research · 2018Article
- Drospirenone-Containing Oral Contraceptive Pills and the Risk of Venous Thromboembolism: An Assessment of Risk in First-Time Users and Restarters.Drug safety · 2017Article
- Disproportional increase of pulmonary embolism in young females in Germany: trends from 2005 to 2014.Journal of thrombosis and thrombolysis · 2017Article
- Incidence of actionable findings on contrast enhanced magnetic resonance angiography ordered for pulmonary embolism evaluation.European journal of radiology · 2016Observational
- Low dose oestrogen combined oral contraception and risk of pulmonary embolism, stroke, and myocardial infarction in five million French women: cohort study.BMJ (Clinical research ed.) · 2016Article
- Commentary on hormonal contraceptive use in Ireland: trends and co-prescribing practices.British journal of clinical pharmacology · 2016Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the risk of non-fatal idiopathic venous thromboembolism in current users of a combined oral contraceptive containing drospirenone, relative to current users of preparations containing levonorgestrel.
designNested case-control study.
settingUK General Practice Research Database.
participantsWomen aged 15-44 years without major risk factors for venous thromboembolism who started a new episode of use of an oral contraceptive containing 30 µg oestrogen in combination with either drospirenone or levonorgestrel between May 2002 and September 2009. Cases were women with a first diagnosis of venous thromboembolism; up to four controls, matched by age, duration of recorded information, and general practice, were randomly selected for each case.
main outcome measuresOdds ratios and 95% confidence intervals estimated with conditional logistic regression; age adjusted incidence rate ratio estimated with Poisson regression.
results61 cases of idiopathic venous thromboembolism and 215 matched controls were identified. In the case-control analysis, current use of the drospirenone contraceptive was associated with a threefold higher risk of non-fatal idiopathic venous thromboembolism compared with levonorgestrel use; the odds ratio adjusted for body mass index was 3.3 (95% confidence interval 1.4 to 7.6). Subanalyses suggested that referral, diagnostic, first time user, duration of use, and switching biases were unlikely explanations for this finding. The crude incidence rate was 23.0 (95% confidence interval 13.4 to 36.9) per 100,000 woman years in current users of drospirenone and 9.1 (6.6 to 12.2) per 100,000 woman years in current users of levonorgestrel oral contraceptives. The age adjusted incidence rate ratio was 2.7 (1.5 to 4.7).
conclusionsThese findings contribute to emerging evidence that the combined oral contraceptive containing drospirenone carries a higher risk of venous thromboembolism than do formulations containing levonorgestrel.
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