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Comparison of a transdermal contraceptive patch vs. oral contraceptives on hemostasis variables

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Author: Kluft, C. · Meijer, P. · LaGuardia, K.D. · Fisher, A.C.
Type:article
Date:2008
Institution: TNO Kwaliteit van Leven
Source:Contraception, 2, 77, 77-83
Identifier: 240619
doi: doi:10.1016/j.contraception.2007.10.004
Keywords: Health · Fibrin · Monophasic · Procoagulation · Prothrombin · Triphasic · contraceptive agent · D dimer · desogestrel plus ethinylestradiol · ethinylestradiol plus levonorgestrel · fibrin degradation product · oral contraceptive agent · plasmin inhibitor · protein S · prothrombin · sex hormone binding globulin · activated protein C resistance · adult · article · blood clotting · blood sampling · clinical trial · controlled clinical trial · controlled study · drug mechanism · female · hemostasis · human · intermethod comparison · major clinical study · open study · patch test · randomized controlled trial · Administration, Cutaneous · Administration, Oral · Adolescent · Adult · Antifibrinolytic Agents · Biological Markers · Blood Coagulation · Blood Coagulation Factors · Contraceptives, Oral, Combined · Desogestrel · Ethinyl Estradiol · Female · Fibrin Fibrinogen Degradation Products · Homeostasis · Humans · Levonorgestrel · Middle Aged · Peptide Fragments · Plasmin · Prospective Studies · Protein Precursors · Prothrombin

Abstract

Purpose: The aim of this study was to compare effects of the transdermal contraceptive patch, a desogestrel/ethinyl estradiol (EE)-containing, monophasic combination oral contraceptive (COC) and a levonorgestrel/EE-containing, triphasic COC on hemostasis variables. Study Design: This was a randomized, open-label study of 104 young women who received six cycles of treatment. Blood was collected at baseline and on treatment; changes by Day 20/Cycle 6 in baseline hemostasis markers [prothrombin fragment 1+2 (F 1+2), plasmin-plasmin inhibitor complex (PAP) and fibrin degradation products (d-dimer)] were assessed. Results: All contraceptives induced similar increases in F 1+2 and d-dimer. Patch-induced PAP increases were less than with the monophasic and similar to the triphasic COC. Decreases in protein S and increases in sex hormone-binding globulin were greater with the patch than with either COC. Patch-induced increases in activated protein C resistance were greater than with the triphasic and similar to the monophasic COC. Conclusion: These contraceptives appeared to accelerate baseline procoagulation processes to a similar extent and to change coagulation potency variables differently. © 2008 Elsevier Inc. All rights reserved.