Oral Contraceptives and the Risk of Gall Bladder Disease: A Comparative Safety Study
The Canadian Medical Association Journal has recently conducted a comparative study regarding the use of oral contraceptives and gall bladder disease. An excerpt from this study is listed below.
Background: Recent concerns have been raised about the risk of gallbladderdisease associated with the use of drospirenone, a fourth-generationprogestin used in oral contraceptives. We conducted a studyto determine the magnitude of this risk compared with otherformulations of oral contraceptives.
Methods: We conducted a retrospective cohort study using the IMS LifeLinkHealth Plan Claims Database. We included women who were usingan oral contraceptive containing ethinyl estradiol combinedwith a progestin during 1997–2009. To be eligible, womenhad to have been taking the oral contraceptive continuouslyfor at least six months. We computed adjusted rate ratios (RRs)for gallbladder disease using a Cox proportional hazards model.In the primary analysis, gallbladder disease was defined ascholecystectomy; in a secondary analysis, it was defined ashospital admission secondary to gallbladder disease.
Results: We included 2 721 014 women in the cohort, 27 087 of whom underwentsurgical or laparoscopic cholecystectomy during the follow-upperiod. Compared with levonorgestrel, an older second-generationprogestin, a small, statistically significant in crease in therisk ofgallbladder disease was associated with desogestrel (adjustedRR 1.05, 95% confidence interval [CI] 1.01–1.09), drospirenone(adjusted RR 1.20, 95% CI 1.16–1.26) and norethindrone(adjusted RR 1.10, 95% CI 1.06–1.14). No statisticallysignificant increase in risk was associated with the other formulationsof oral contraceptive (ethynodiol diacetate, norgestrel andnorgestimate).
Mahyar Etminan, Joseph A.C. Delaney, Brian Bressler and James M. Brophy
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