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Human Reproduction, Vol. 14, No. 6, 1500-1505, June 1999
© 1999 European Society of Human Reproduction and Embryology

Venous thromboembolic disease and combined oral contraceptives: A re-analysis of the MediPlus database

J.-C. Todd1, R. Lawrenson1,3, R.D.T. Farmer1, T.J. Williams1 and G.M. Leydon2

1 European Institute of Health and Medical Sciences, University of Surrey, Surrey Research Park, Guildford GU2 5RF, and 2 Cancer and Public Health Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK

In October 1995 the Committee on Safety of Medicines advised UK doctors and pharmacists that oral contraceptives containing desogestrel and gestodene were associated with double the risk of venous thromboembolic events (VTE) compared to pills containing other progestogens. In 1997 data was analysed from the MediPlus database of UK general practitioner records, which reported odds ratios for desogestrel and gestodene lower than that for levonorgestrel. Here the results of a more stringent nested case control analysis on the MediPlus database are reported. The study was larger and cases were verified. A crude incidence of idiopathic VTE was found amongst users of combined oral contraceptives of 4.6 per 10 000 exposed women years. Using levonorgestrel 150 µg + ethinyloestradiol 30 µg as reference, non-significant odds ratios of 1.1 (0.5–2.6) for desogestrel 150 µg + ethinyloestradiol 30 µg and 1.1 (0.5–2.4) for gestodene 75 µg + ethinyloestradiol 30 µg were found. The results of this study show no significant difference in risk between different formulations of combined oral contraceptive.

Key words: case control/oral contraceptives/pill scare/study Mediplus database/venous thromboembolic disease

3 To whom correspondence should be addressed


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