title: Investigation of the hemostatic effect of a transdermal patch containing 0.55 mg ethinyl estradiol and 2.1 mg gestodene compared with a monophasic oral contraceptive containing 0.03 mg ethinyl estradiol and 0.15 mg levonorgestrel: an open-label, randomized, crossover study.
abstract: BACKGROUND
  Transdermal delivery of contraceptives offers several advantages over combined oral contraceptives (COCs), including effective absorption and the provision of relatively constant serum concentrations. Ethinyl estradiol (EE) and the progestin gestodene are well-absorbed through the skin and, therefore, well-suited for use in a transdermal contraceptive patch.
  
  
  OBJECTIVE
  The objective of this study was to investigate the impact of a once-weekly transparent, transdermal patch delivering low doses of EE and gestodene equivalent to a COC containing 0.02 mg EE and 0.06 mg gestodene on hemostasis parameters compared with a monophasic COC containing 0.03 mg EE and 0.15 mg levonorgestrel.
  
  
  METHODS
  In this single-center, open-label, randomized, crossover study, 30 women (aged 18-35 years) received three cycles of each treatment, separated by a two-cycle washout period. The primary outcome measure was the absolute change from baseline in prothrombin fragments 1 + 2 and D-dimer.
  
  
  RESULTS
  For both treatments, prothrombin fragments 1 + 2 remained stable during the first treatment period, and increased only slightly in the second period (mean absolute change 0.025 and 0.028 nmol/L in the novel Bayer patch and COC groups, respectively). Increases in D-dimer were observed in both periods (mean absolute change 107.0 ± 147.2 ng/L for the novel Bayer patch and 113.7 ± 159.0 ng/L for the COC). There were no statistically significant treatment differences in prothrombin 1 + 2 or D-dimer (p = 0.667 and p = 0.884, respectively) and no statistically significant treatment sequence or period effects.
  
  
  CONCLUSIONS
  A COC containing 0.03 mg EE and 0.15 mg levonorgestrel and the novel Bayer patch have comparable influence on hemostatic endpoints. Both treatments were well-tolerated by subjects.
authors.affiliation: Laboratorium für Klinische Forschung, Schwentinental, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Junge
authors.forename: Doris
authors.initials: D
authors.lastname: Heger-Mahn
authors.forename: Dietmar
authors.initials: D
authors.lastname: Trummer
authors.forename: Martin
authors.initials: M
authors.lastname: Merz
mesh_terms: D000293:Adolescent; D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D005260:Female; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D009652:Norpregnenes / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D010349:Patient Compliance; D011517:Prothrombin Time; D057968:Transdermal Patch; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D009652:Norpregnenes; C033273:Gestodene; D004997:Ethinyl Estradiol; D016912:Levonorgestrel
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