Peking Union Medical College Hospital, Beijing, China.
Clin Drug Investig. 2010;30(6):387-96. doi: 10.1007/BF03256908.
To evaluate and compare the contraceptive efficacy, bleeding pattern, side effects and other positive effects of a combined oral contraceptive (COC) containing drospirenone (DRSP) [Yasmin] with those of a COC containing desogestrel (DSG) in healthy Chinese women. This was a randomized, open-label, controlled, multicentre study of 768 healthy Chinese women requiring contraception. The subjects were randomized to ethinylestradiol (EE) 30 microg/DRSP 3 mg (n = 573) or EE 30 microg/ DSG 150 microg (n = 195), at a ratio of 3 : 1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment. Weight, height and body mass index were evaluated at each visit. The Menstrual Distress Questionnaire (MDQ) was administered at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). Baseline characteristics were similar between the two groups (p > 0.05). The Pearl Index (method failure) for EE/DRSP was 0.208 per 100 women-years, which was lower than that for EE/DSG (0.601 per 100 women-years). There were no significant differences between the treatment groups with regard to bleeding patterns. According to the MDQ subscale, improvements in water retention and increases in appetite during the intermenstrual period and in water retention and general well-being during the menstrual period in the EE/DRSP group (-0.297, -0.057, 0.033 and 0.150, respectively) were significantly improved compared with the EE/DSG group (-0.108, 0.023, 0.231 and -0.023, respectively) [all p < 0.05]. Other values that improved in both groups, particularly improvement in breast pain and tenderness and skin condition, were more evident in the EE/DRSP group (18.0%, 89/494; 12.6%, 62/494) than in the EE/DSG group (11.3%, 19/168; 5.4%, 9/168). Mean weight increased in the EE/DSG group (0.57 kg) while there was a significant decrease in mean weight (-0.28 kg) in the EE/DRSP group (p < 0.01). Both EE/DRSP and EE/DSG have good contraceptive efficacy and a comparable bleeding pattern. EE/DRSP had a more favourable effect on weight and premenstrual symptoms than EE/DSG.
目的 评价和比较含有屈螺酮(DRSP)[Yasmin]的复方口服避孕药(COC)与含有去氧孕烯(DSG)的 COC 在中国健康女性中的避孕效果、出血模式、副作用和其他正性效应。
方法 这是一项在中国 768 例健康需要避孕的女性中进行的随机、开放标签、对照、多中心研究。受试者按照 3:1 的比例随机分为屈螺酮 3mg/炔雌醇 30μg(n=573)或去氧孕烯 150μg/炔雌醇 30μg(n=195)组。每个个体接受 13 个周期的治疗。在治疗的第 4、7、10 和 13 个周期时需要进一步就诊。每次就诊时均评估体重、身高和体重指数。在基线、第 3 次就诊(第 7 个周期)和第 5 次就诊(第 13 个周期后)时采用月经困扰问卷(MDQ)进行评估。两组的基线特征相似(p>0.05)。屈螺酮/炔雌醇的 Pearl 指数(方法失败)为每 100 名女性-年 0.208,低于屈螺酮/去氧孕烯组的每 100 名女性-年 0.601。两组在出血模式方面无显著差异。根据 MDQ 亚量表,屈螺酮/炔雌醇组在经间期水潴留和食欲增加(-0.297、-0.057、0.033 和 0.150)以及月经期间水潴留和总体健康状况(-0.108、0.023、0.231 和-0.023)方面的改善明显优于屈螺酮/去氧孕烯组(均 p<0.05)。两组中均改善的其他指标,尤其是乳房疼痛和触痛以及皮肤状况的改善,在屈螺酮/炔雌醇组(18.0%,89/494;12.6%,62/494)中比屈螺酮/去氧孕烯组(11.3%,19/168;5.4%,9/168)更为明显。屈螺酮/去氧孕烯组的平均体重增加(0.57kg),而屈螺酮/炔雌醇组的平均体重显著下降(-0.28kg,p<0.01)。屈螺酮/炔雌醇和屈螺酮/去氧孕烯均具有良好的避孕效果和相似的出血模式。与屈螺酮/去氧孕烯相比,屈螺酮/炔雌醇对体重和经前期症状有更有利的影响。