Comparison of a transdermal contraceptive patch vs. oral contraceptives on hemostasis variables.
OBJECTIVE
The aim of this study was to compare effects of the transdermal contraceptive patch, a desogestrel/ethinyl estradiol (EE)-containing, monophasic combination oral contraceptive (COC) and a levonorgestrel/EE-containing, triphasic COC on hemostasis variables.


METHODS
This was a randomized, open-label study of 104 young women who received six cycles of treatment. Blood was collected at baseline and on treatment; changes by Day 20/Cycle 6 in baseline hemostasis markers [prothrombin fragment 1+2 (F 1+2), plasmin-plasmin inhibitor complex (PAP) and fibrin degradation products (D-dimer)] were assessed.


RESULTS
All contraceptives induced similar increases in F 1+2 and D-dimer. Patch-induced PAP increases were less than with the monophasic and similar to the triphasic COC. Decreases in protein S and increases in sex hormone-binding globulin were greater with the patch than with either COC. Patch-induced increases in activated protein C resistance were greater than with the triphasic and similar to the monophasic COC.


CONCLUSIONS
These contraceptives appeared to accelerate baseline procoagulation processes to a similar extent and to change coagulation potency variables differently.
Kluft
Cornelis
C
Gaubius Laboratory, TNO-Quality of Life, Biomedical Research, Leiden, The Netherlands.
Meijer
Piet
P
LaGuardia
Katherine D
KD
Fisher
Alan C
AC
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000933:Antifibrinolytic Agents / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects*; D001779:Blood Coagulation Factors / Q000378:metabolism; D003277:Contraceptives, Oral, Combined; D017135:Desogestrel / Q000008:administration & dosage*; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin
D000933:Antifibrinolytic Agents; D015415:Biomarkers; D001779:Blood Coagulation Factors; D003277:Contraceptives, Oral, Combined; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D011498:Protein Precursors; C036309:fibrin fragment D; D004997:Ethinyl Estradiol; D016912:Levonorgestrel; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D017135:Desogestrel; D011516:Prothrombin; D005341:Fibrinolysin