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Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen
Journal article   Open access   Peer reviewed

Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen

Arielle Mendel, Sasha Bernatsky, Christian A. Pineau, Yvan St-Pierre, John G. Hanly, Murray B. Urowitz, Ann E. Clarke, Juanita Romero-Diaz, Caroline Gordon, Sang-Cheol Bae, …
Rheumatology (Oxford, England), v 58(7), pp 1259-1267
01 Jul 2019
DOI: https://doi.org/10.1093/rheumatology/kez014
PMID: 30753683
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc6821299View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open
url
https://doi.org/10.1093/rheumatology/kez014View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Rheumatology Science & Technology
Objectives To assess the prevalence of combined hormonal contraceptives (CHCs) in reproductive-age women with SLE with and without possible contraindications and to determine factors associated with their use in the presence of possible contraindications. Methods This observational cohort study included premenopausal women ages 18-45 years enrolled in the SLICC Registry 15 months after SLE onset, with annual assessments spanning 2000-2017. World Health Organization Category 3 or 4 contraindications to CHCs (e.g. hypertension, aPL) were assessed at each study visit. High disease activity (SLEDAI score >12 or use of >0.5 mg/kg/day of prednisone) was considered a relative contraindication. Results A total of 927 SLE women contributed 6315 visits, of which 3811 (60%) occurred in the presence of one or more possible contraindication to CHCs. Women used CHCs during 512 (8%) visits, of which 281 (55%) took place in the setting of one or more possible contraindication. The most frequently observed contraindications were aPL (52%), hypertension (34%) and migraine with aura (22%). Women with one or more contraindication were slightly less likely to be taking CHCs [7% of visits (95% CI 7, 8)] than women with no contraindications [9% (95% CI 8, 10)]. Conclusion CHC use was low compared with general population estimates (>35%) and more than half of CHC users had at least one possible contraindication. Many yet unmeasured factors, including patient preferences, may have contributed to these observations. Further work should also aim to clarify outcomes associated with this exposure.

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9 citations in Web of Science
8 citations in Scopus

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Rheumatology
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