title: Efficacy, safety, and tolerability of a monophasic oral contraceptive containing nomegestrol acetate and 17β-estradiol: a randomized controlled trial.
abstract: OBJECTIVE
  To estimate the efficacy, cycle control, tolerability, and safety of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-estradiol (E2) in comparison with drospirenone and ethinyl E2.
  
  
  METHODS
  In a randomized, open-label, comparative multicenter trial, healthy women (n=2,281; age 18-50 years) at risk for pregnancy and in need of contraception were allocated in a 3:1 ratio to receive nomegestrol acetate (2.5 mg) and 17β-E2 (1.5 mg) in a 24-4-day regimen (investigational drug) or drospirenone (3.0 mg) and ethinyl E2 (30 micrograms) in a 21-7-day regimen (comparator) for 13 consecutive, 28-day cycles. The primary end point was the Pearl Index.
  
  
  RESULTS
  The Pearl Indices for 18- to 35-year-old women in the investigational (n=1,375) and comparator (n=463) groups were 1.27 (95% confidence interval [CI] 0.66-2.22) and 1.89 (95% CI 0.69-4.11), respectively. Respective 1-year cumulative pregnancy rates were 1.22 (95% CI 0.69-2.16) and 1.82 (95% CI 0.81-4.05). By the end of the trial, shorter, lighter scheduled bleeding or an absence of scheduled bleeding occurred with greater frequency (32.9%) in the investigational group, whereas unscheduled bleeding or spotting episodes were low (16.2% and 15.0% in the investigational and comparator groups, respectively). Acne prevalence decreased from approximately 33% at baseline to 22% and 14% at cycle 13 in the respective groups. In the investigational group, the most frequently reported adverse events were acne (16.4%), weight gain (9.5%), and irregular withdrawal bleeding (9.1%).
  
  
  CONCLUSIONS
  Nomegestrol acetate and 17β-E2 were well tolerated and provided excellent contraceptive efficacy and acceptable cycle control.
  
  
  BACKGROUND
  Clinicaltrials.gov, www.clinicaltrials.gov, NCT00413062.
  
  
  METHODS
  I.
authors.affiliation: Columbia University, New York, NY 10032, USA. clw3@columbia.edu
authors.forename: Carolyn
authors.initials: C
authors.lastname: Westhoff
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Kaunitz
authors.forename: Tjeerd
authors.initials: T
authors.lastname: Korver
authors.forename: Werner
authors.initials: W
authors.lastname: Sommer
authors.forename: Luis
authors.initials: L
authors.lastname: Bahamondes
authors.forename: Philip
authors.initials: P
authors.lastname: Darney
authors.forename: Carole
authors.initials: C
authors.lastname: Verhoeven
mesh_terms: D000293:Adolescent; D000328:Adult; D000736:Androstenes / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008535:Megestrol / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009649:Norpregnadienes / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D016016:Proportional Hazards Models; D055815:Young Adult
chemical_list: D000736:Androstenes; D003277:Contraceptives, Oral, Combined; D009649:Norpregnadienes; D004997:Ethinyl Estradiol; D004958:Estradiol; C038501:nomegestrol acetate; D008535:Megestrol; C035144:drospirenone