Evidence map›Paper›PMID 39551952›Full record

SynthesisCPT: pharmacometrics & systems pharmacology2024

Development of breakthrough bleeding model of combined-oral contraceptives utilizing model-based meta-analysis.

Huili Chen, Dain Chun, Karthik Lingineni, Serge Guzy, Rodrigo Cristofoletti, Joachim Hoechel, Tianze Jiao, Brian Cicali, Valvanera Vozmediano, Stephan Schmidt

Abstract readMeta-Analysis
In one paragraph

Synthesis in CPT: pharmacometrics & systems pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. Pooled it
  2. Article
  3. Article
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

10 authors.

Huili ChenDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0009-0003-2233-727X
Dain ChunDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.
Karthik LingineniDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0000-0003-1272-8093
Serge GuzyDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0009-0000-6342-9611
Rodrigo CristofolettiDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0000-0003-2619-0343
Joachim HoechelBayer AG, Berlin, Germany.
Tianze JiaoDepartment of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.ORCID 0000-0002-2608-616X
Brian CicaliDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0000-0002-7932-8599
Valvanera VozmedianoDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0000-0002-2636-1889
Stephan SchmidtDepartment of Pharmaceutics, College of Pharmacy, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA.ORCID 0000-0002-4998-1167

Funding

Gates Foundation INV-010213Gates Foundation OPP1185454
6 · The paper itself

Abstract

Breakthrough bleeding (BTB) is a common side effect of hormonal contraception and is thought to impact adherence to combined oral contraceptives (COCs) but respective dose-response relationships are not yet fully understood. Therefore, the objective of this model-based meta-analysis (MBMA) was to establish dose-response for COCs containing different progestin/EE combinations using BTB as the pharmacodynamic endpoint. Data from 25 studies containing BTB information of 4 progestins (desogestrel, drospirenone, gestodene, and levonorgestrel) in combination with ethinyl estradiol (EE) at various dose levels was used for this analysis. The results of our MBMA show that BTB is significantly increased upon initiation of COC use but subsides over time. The time needed for BTB to return to baseline depends on the EE dose and differs marginally between progestins during the initial months of use at the same EE dose. BTB typically returns to baseline within 3 months at the highest (30 μg) dose, whereas it can take significantly longer to reestablish a regular bleeding pattern at lower EE doses (15 and 20 μg), irrespective of the progestin used. The dose-response relationships established for BTB across different progestin/EE combinations can now be used to support the selection of optimal COC dosing/treatment regimens and serve as the scientific basis for evaluating the impact of clinically relevant factors, including drug-drug interactions and demographics, on BTB.

Indexed as

Contraceptives, Oral, CombinedDose-Response Relationship, DrugEthinyl EstradiolDesogestrelFemaleHumansLevonorgestrelModels, BiologicalNorpregnenesProgestinsContraceptives, Oral, CombinedDesogestrelEthinyl EstradiolGestodeneLevonorgestrelNorpregnenesProgestins

Identifiers

PMID39551952
PMCPMC11578130

What OpenQuestion holds

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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.