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. 2000 Aug;321(7259):477-9.
doi: 10.1136/bmj.321.7259.477.

Effect of 1995 pill scare on rates of venous thromboembolism among women taking combined oral contraceptives: analysis of general practice research database

R D Farmer  1 , T J Williams, E L Simpson, A L Nightingale
Affiliations

Effect of 1995 pill scare on rates of venous thromboembolism among women taking combined oral contraceptives: analysis of general practice research database

R D Farmer et al. BMJ. 2000 Aug.

Abstract

Objective: To compare the incidence of venous thromboembolism among women taking combined oral contraceptives before and after the October 1995 pill scare.

Design: Analysis of General Practice Research Database.

Setting: United Kingdom, January 1993 to December 1998.

Subjects: Women aged 15-49 taking combined oral contraceptives.

Main outcome measures: Incidence of venous thromboembolism.

Results: Use of so called "third generation" combined oral contraceptives fell from 53% during January 1993 to October 1995 to 14% during November 1995 to December 1998. There was no significant change in the incidence of venous thromboembolism between the two periods after age was adjusted for (incidence ratio 1.04, 95% confidence interval 0.78 to 1.39).

Conclusions: The findings are not compatible with the assertion that third generation oral contraceptives are associated with a twofold increase in risk of venous thromboembolism compared with older progestogens.

PIP: In October 1995 the UK Committee on Safety of Medicines advised that combined oral contraceptives (OCs) containing either gestodene or desogestrel were associated with twice the risk of venous thromboembolism compared with older products. This study was conducted to compare the incidence of venous thromboembolism among women taking combined OCs before and after the October 1995 pill scare. Using data from the General Practice Research Database, a total of 304 practices were analyzed. Overall, results show that use of third-generation combined OCs fell from 53% during the period of January 1993 to October 1995 to 14% during the period of November 1995 to December 1998. No significant change was noted in the incidence of venous thromboembolism between the two periods after age was adjusted for (incidence ratio, 1.04; 95% confidence interval, 0.78-1.39). Based on these findings, it is concluded that third-generation OCs are not associated with a twofold increase in risk of venous thromboembolism compared with older progestogens.

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Figures

Figure
Figure
Number of cases of venous thromboembolism by month of occurrence, January 1993-December 1998
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References

    1. Committee on Safety of Medicines. Combined oral contraceptives and thromboembolism. London: CSM; 1995.
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