Nappi Rossella E, Paoletti Anna Maria, Volpe Annibale, Chiovato Luca, Howard Brandon, Weiss Herman, Ricciotti Nancy
* Research Center for Reproductive Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia , Pavia , Italy.
Eur J Contracept Reprod Health Care. 2014 Aug;19(4):285-94. doi: 10.3109/13625187.2014.918596. Epub 2014 Jun 13.
To evaluate the impact of a 91-day extended regimen combined oral contraceptive (150 μg levonorgestrel [LNG]/30 μg ethinylestradiol [EE] for 84 days, followed by 10 μg EE for seven days [Treatment 1]) compared with two traditional 21/7 regimens (21 days 150 μg LNG/30 μg EE [Treatment 2] or 150 μg desogestrel [DSG]/30 μg EE [Treatment 3], both with seven days' hormone free), on several coagulation factors and thrombin formation markers.
Randomised, open-label, parallel-group comparative study involving healthy women (18-40 years). The primary endpoint was change from baseline in prothrombin fragment 1 + 2 (F1 + 2) levels over six months.
A total of 187 subjects were included in the primary analysis. In all groups, mean F1 + 2 values were elevated after six months of treatment. Changes were comparable between Treatments 1 and 2 (least squares mean change: 170 pmol/L and 158 pmol/L, respectively) but noticeably larger after Treatment 3 (least squares mean change: 592 pmol/L). The haemostatic effects of Treatment 1 were comparable to those of Treatment 2 and noninferior to those of Treatment 3 (lower limit of 95% confidence interval [- 18.3 pmol/L] > - 130 pmol/L).
The LNG/EE regimens had similar effects on F1 + 2. Noninferiority was demonstrated between extended regimen LNG/EE and DSG/EE.
评估一种91天延长方案复方口服避孕药(84天服用150μg左炔诺孕酮[LNG]/30μg炔雌醇[EE],随后7天服用10μg EE[治疗1])与两种传统的21/7方案(21天服用150μg LNG/30μg EE[治疗2]或150μg去氧孕烯[DSG]/30μg EE[治疗3],两种方案均有7天无激素期)对几种凝血因子和凝血酶形成标志物的影响。
对健康女性(18 - 40岁)进行随机、开放标签、平行组比较研究。主要终点是六个月内凝血酶原片段1 + 2(F1 + 2)水平相对于基线的变化。
共有187名受试者纳入主要分析。在所有组中,治疗六个月后平均F1 + 2值均升高。治疗1和治疗2之间的变化相当(最小二乘均值变化分别为170 pmol/L和158 pmol/L),但治疗3后变化明显更大(最小二乘均值变化为592 pmol/L)。治疗1的止血效果与治疗2相当,且不劣于治疗3(95%置信区间下限[-18.3 pmol/L] > -130 pmol/L)。
LNG/EE方案对F1 + 2有相似影响。延长方案LNG/EE与DSG/EE之间证明了非劣效性。