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Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen
- Source :
- Rheumatology (Oxford, England), 58(7), 1259-1267. Oxford University Press, Rheumatology (Oxford, England), vol 58, iss 7
- Publication Year :
- 2019
-
Abstract
- Objectives To 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. Methods This 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. Results A 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)]. Conclusion CHC 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.
- Subjects :
- Migraine with Aura
Practice Patterns
Severity of Illness Index
Cohort Studies
0302 clinical medicine
systemic lupus erythematosus
Prednisone
Risk Factors
Epidemiology
Lupus Erythematosus, Systemic
Pharmacology (medical)
Registries
Practice Patterns, Physicians'
030219 obstetrics & reproductive medicine
Combined
Contraceptives
Clinical Science
Antiphospholipid Syndrome
Patient preference
anti-phospholipid syndrome
Contraceptives, Oral, Combined
contraception
Hypertension
Public Health and Health Services
Educational Status
Female
epidemiology
medicine.symptom
Drug
Cohort study
medicine.drug
Oral
Adult
medicine.medical_specialty
Adolescent
Clinical Sciences
Immunology
Lupus
Autoimmune Disease
Contraceptives, Oral, Hormonal
03 medical and health sciences
Young Adult
Rheumatology
Antiphospholipid syndrome
Clinical Research
Internal medicine
medicine
Humans
Contraindication
030203 arthritis & rheumatology
Physicians'
Lupus Erythematosus
Hormonal
business.industry
Contraindications
Contraception/Reproduction
Systemic
Contraindications, Drug
medicine.disease
Migraine with aura
Drug Utilization
Arthritis & Rheumatology
Good Health and Well Being
business
Hormone
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 58
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Rheumatology (Oxford, England)
- Accession number :
- edsair.doi.dedup.....55ae6b74a3d11c59dc63b97718f95e8a