Evidence map›Paper›PMID 30753683›Full record

Observational studyRheumatology (Oxford, England)2019

Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen.

Arielle Mendel, Sasha Bernatsky, Christian A Pineau, Yvan St-Pierre, John G Hanly, Murray B Urowitz, Ann E Clarke, Juanita Romero-Diaz, Caroline Gordon, Sang-Cheol Bae and 34 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Rheumatology (Oxford, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

44 authors.

Arielle MendelDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada.
Sasha BernatskyDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada.
Christian A PineauDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada.
Yvan St-PierreDivision of Clinical Epidemiology, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
John G HanlyDivision of Rheumatology, Department of Medicine and Department of Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
Murray B UrowitzCentre for Prognosis Studies in the Rheumatic Disease and Krembil Research Institute, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Ann E ClarkeDivision of Rheumatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Juanita Romero-DiazDivision of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico.
Caroline GordonRheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Sang-Cheol BaeDepartment of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
Daniel J WallaceCedars-Sinai Medical Centre, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Joan T MerrillDepartment of Clinical Pharmacology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.
Jill BuyonDivision of Rheumatology, Department of Medicine, New York School of Medicine, New York, NY, USA.
David A IsenbergCentre for Rheumatology, Department of Medicine, University College London, London, UK.
Anisur RahmanCentre for Rheumatology, Department of Medicine, University College London, London, UK.
Ellen M GinzlerDepartment of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
Michelle PetriDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Mary Anne DooleyThurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
Paul FortinDivision of Rheumatology, Centre Hospitalier Universitaire de Québec et Université Laval, Québec City, Quebec, Canada.
Dafna D GladmanCentre for Prognosis Studies in the Rheumatic Disease and Krembil Research Institute, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Kristján SteinssonCenter for Rheumatology Research, Landspitali University hospital, Reykjavik, Iceland.
Rosalind Ramsey-GoldmanDivision of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Munther A KhamashtaLupus Research Unit, Rayne Institute, St Thomas' Hospital, King's College London School of Medicine, London, UK.
Cynthia AranowFeinstein Institute for Medical Research, Manhasset, NY, USA.
Meggan MackayFeinstein Institute for Medical Research, Manhasset, NY, USA.
Graciela AlarcónDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Susan ManziLupus Center of Excellence, Allegheny Health Network, Pittsburgh, PA, USA.
Ola NivedDepartment of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden.
Andreas JönsenDepartment of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden.
Asad A ZomaLanarkshire Centre for Rheumatology, Hairmyres Hospital, East Kilbride, UK.
Ronald F van VollenhovenUnit for Clinical Therapy Research (ClinTRID), Karolinska Institute, Stockholm, Sweden.
Manuel Ramos-CasalsJoseph Font Autoimmune Diseases Laboratory, IDIBAPS, Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain.
Giuillermo Ruiz-IrastorzaAutoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain.
Sam LimDivision of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA.
Kenneth C KalunianUniversity of California San Diego School of Medicine, La Jolla, CA, USA.
Murat InancDivision of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Diane L KamenDepartment of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Christine A PeschkenDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Søren JacobsenCopenhagen Lupus and Vasculitis Clinic, Section 4242, Center for Rheumatology and Spine Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Anca AskanaseDivision of Rheumatology, Columbia University Medical Center, New York, NY, USA.
Jorge Sanchez-GuerreroDepartment of Rheumatology, Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada.
Ian N BruceArthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal and Dermatological Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Nathalie Costedoat-ChalumeauCentre de Reference Maladies Auto-immunes et Systemiques Rares, Service de Medecine Interne, Hospital Cochin, Paris, France.
Evelyne VinetDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, Canada.

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
Hopkins Lupus CohortR01AR069572 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI PETRI, MICHELLE A · 2016 to 2020
$3.4M
NCATS NIH HHS UL1 TR001422NIAMS NIH HHS R01 AR069572
6 · The paper itself

Abstract

objectivesTo assess the prevalence of combined hormonal contraceptives (CHCs) in reproductive-age women with SLE with and without possible contraindications and to determine factors associated with their use in the presence of possible contraindications.

methodsThis observational cohort study included premenopausal women ages 18-45 years enrolled in the SLICC Registry ⩽15 months after SLE onset, with annual assessments spanning 2000-2017. World Health Organization Category 3 or 4 contraindications to CHCs (e.g. hypertension, aPL) were assessed at each study visit. High disease activity (SLEDAI score >12 or use of >0.5 mg/kg/day of prednisone) was considered a relative contraindication.

resultsA total of 927 SLE women contributed 6315 visits, of which 3811 (60%) occurred in the presence of one or more possible contraindication to CHCs. Women used CHCs during 512 (8%) visits, of which 281 (55%) took place in the setting of one or more possible contraindication. The most frequently observed contraindications were aPL (52%), hypertension (34%) and migraine with aura (22%). Women with one or more contraindication were slightly less likely to be taking CHCs [7% of visits (95% CI 7, 8)] than women with no contraindications [9% (95% CI 8, 10)].

conclusionCHC use was low compared with general population estimates (>35%) and more than half of CHC users had at least one possible contraindication. Many yet unmeasured factors, including patient preferences, may have contributed to these observations. Further work should also aim to clarify outcomes associated with this exposure.

Indexed as

AdolescentAdultAntiphospholipid SyndromeCohort StudiesContraceptives, Oral, CombinedContraceptives, Oral, HormonalContraindications, DrugDrug UtilizationEducational StatusFemaleHumansHypertensionLupus Erythematosus, SystemicMigraine with AuraPractice Patterns, Physicians'RegistriesContraceptives, Oral, CombinedContraceptives, Oral, Hormonalanti-phospholipid syndromecontraceptionepidemiologysystemic lupus erythematosus

Identifiers

PMID30753683
PMCPMC6821299

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.