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醋酸甲羟孕酮皮下注射104毫克后出血模式的变化

Changes in bleeding patterns with depot medroxyprogesterone acetate subcutaneous injection 104 mg.

作者信息

Arias Raquel D, Jain John K, Brucker Cosima, Ross Doug, Ray Amrit

机构信息

Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.

出版信息

Contraception. 2006 Sep;74(3):234-8. doi: 10.1016/j.contraception.2006.03.008. Epub 2006 Jun 30.

Abstract

OBJECTIVE

This study aims to assess changes in bleeding patterns with the use of depot medroxyprogesterone acetate (DMPA) 104 mg/0.65 ml subcutaneous injection (DMPA-SC 104).

STUDY DESIGN

An analysis was conducted using data from two 1-year, noncomparative clinical trials (N=1787) and a 2-year randomized study comparing DMPA-SC 104 (N=266) with DMPA intramuscular injection (DMPA-IM). Bleeding was analyzed per 30-day interval by category and number of days. Analyses also were performed for age and body mass index (BMI) subgroups and for the percentages of women shifting from bleeding/spotting to amenorrhea after each injection.

RESULTS

Each study showed decreased incidence of irregular bleeding and increased amenorrhea with continued use of DMPA-SC 104. Rates of amenorrhea at Month 12 (52-64% across studies) and Month 24 (71% in the 2-year trial) were comparable with those originally reported for DMPA-IM. Changes in bleeding patterns showed no consistent differences according to age or BMI. The percentages of subjects shifting from bleeding and/or spotting to amenorrhea increased with each subsequent injection.

CONCLUSION

Clinical data show that the incidence of amenorrhea increases over time with the use of DMPA-SC 104.

摘要

目的

本研究旨在评估使用104毫克/0.65毫升皮下注射醋酸甲羟孕酮(DMPA-SC 104)时出血模式的变化。

研究设计

使用来自两项为期1年的非对照临床试验(N = 1787)的数据以及一项为期2年的随机研究进行分析,该随机研究将DMPA-SC 104(N = 266)与醋酸甲羟孕酮肌肉注射(DMPA-IM)进行比较。按30天间隔对出血情况按类别和天数进行分析。还对年龄和体重指数(BMI)亚组以及每次注射后从出血/点滴出血转变为闭经的女性百分比进行了分析。

结果

每项研究均显示,持续使用DMPA-SC 104后,不规则出血的发生率降低,闭经发生率增加。第12个月(各研究中为52%-64%)和第24个月(两年期试验中为71%)的闭经发生率与最初报道的DMPA-IM相当。出血模式的变化在年龄或BMI方面未显示出一致差异。随着后续每次注射,从出血和/或点滴出血转变为闭经的受试者百分比增加。

结论

临床数据表明,使用DMPA-SC 104时,闭经发生率会随着时间推移而增加。

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