Key result
Combined oral contraceptives containing dienogest and 30 µg ethinylestradiol were associated with a higher risk of venous thromboembolism compared to levonorgestrel preparations (adjusted HR 1.6).
Why the study?
The study was conducted to clarify whether dienogest/ethinylestradiol-containing combined oral contraceptives carry a different risk of venous thromboembolic events compared to levonorgestrel/ethinylestradiol-containing preparations.
Does combined oral contraceptives containing dienogest and 30 µg ethinylestradiol increase the risk of venous thromboembolic events in women compared to levonorgestrel and 30 µg ethinylestradiol?
Meta-Analysis (n=228,122)
Yes
Does combined oral contraceptives containing dienogest and 30 µg ethinylestradiol increase the risk of venous thromboembolic events in women compared to levonorgestrel and 30 µg ethinylestradiol?
Combined oral contraceptives containing dienogest and 30 µg ethinylestradiol are associated with a slightly higher risk of venous thromboembolic events compared to those containing levonorgestrel.
Answers are grounded in this paper and cite their sources.
May warrant preferring levonorgestrel OCs in VTE-prone women; reinforces progestin-specific thrombotic differences.
The European Medicines Agency requested a meta-analysis of four large, multi-national cohort studies on hormonal contraceptives to clarify whether dienogest/ethinylestradiol-containing combined oral contraceptives (DNG/EE) carry a different risk of venous thromboembolic events (VTE) compared to levonorgestrel/ethinylestradiol-containing preparations (LNG/EE). The primary objective of the meta-analysis was to assess VTE risk in a study population that is representative for the actual users of the individual preparations.
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Jürgen Dinger (2020) conducted a meta-analysis in Venous thromboembolism (n=228,122). Dienogest and 30 µg ethinylestradiol vs. Levonorgestrel and 30 µg ethinylestradiol was evaluated on Venous thromboembolic events (VTE) (HR 1.6, 95% CI 1.1-2.3). Combined oral contraceptives containing dienogest and 30 µg ethinylestradiol were associated with a higher risk of venous thromboembolism compared to levonorgestrel preparations (adjusted HR 1.6).
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