AI Article Synopsis
- The study aimed to evaluate how many women with systemic lupus erythematosus (SLE) use combined hormonal contraceptives (CHCs) and the factors affecting their use, especially when potential health risks are present.
- Out of 927 women with SLE, only 8% of visits involved CHC use, with more than half of those users having at least one potential contraindication, such as hypertension and migraines.
- CHC usage was notably lower than the general population, prompting further investigation into reasons like patient preferences that might influence these rates and the necessity for more research on the health impacts of CHC use in this group.
Article Abstract
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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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821299 | PMC |
| http://dx.doi.org/10.1093/rheumatology/kez014 | DOI Listing |
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