[Desogestrel contraceptives: the perfect pill for lipids?].

OBJECTIVES

A review of clinical trials of changes in lipoprotein composition in women receiving oral contraceptives containing desogestrel; a comparison of the trials' findings and a discussion of their clinical significance. METHODOLOGY: Using MEDLINE, we searched for articles published in English and French between 1982 and 1993 and reviewed the references they contained. The criteria for inclusion were: the basic design of the study (randomised prospective or with crossover), the age of the women, the use of a monophasic oral contraceptive containing desogestrel, the length of the trial (minimum 3 months), and comparison of patients' lipoprotein composition before and after treatment. RESULTS: Among the 17 articles identified, eight studies that met the criteria were reviewed. Their findings all pointed in the same general direction, but contained several major biases, making interpretation difficult. Overall, oral contraceptives containing desogestrel tended to have a beneficial effect; however, there was no significant effect on total cholesterol, a slight tendency toward an increase in HDL, and a slight tendency toward a decrease in LDL. An increase in TG was the only constant and significant change. CONCLUSION: Oral contraceptives containing desogestrel appear to have a favourable effect on HDL and LDL; however, their effect is not significant. It is, therefore, too early to conclude that they offer protection against coronary heart disease.