title: Prescribing of cyproterone acetate/ethinylestradiol in UK general practice: a retrospective descriptive study using The Health Improvement Network.
abstract: OBJECTIVE
  To investigate prescribing patterns of cyproterone acetate/ethinylestradiol (CPA/EE) in the United Kingdom before and after the 2013 prescribing guidance.
  
  
  METHODS
  We conducted a retrospective descriptive study in UK general practice. The study population included women with a first prescription (index date) for CPA/EE in The Health Improvement Network in 2011 (N=2760), 2012 (N=2923) and 2014 (N=2341). We evaluated the proportion of new CPA/EE users with (i) a diagnosis of a hyperandrogenic condition, menstrual problem, consultation for contraception management, and other acne treatment, in the year before the index date; and (ii) proportion of new CPA/EE users with concomitant use of another hormonal contraceptive (HC).
  
  
  RESULTS
  The percentage of CPA/EE new users with a record of a hyperandrogenic condition was 61% in 2011, 62% in 2012 and 63% in 2014. Corresponding percentages for acne were 51%, 54% and 55%, respectively. When manually reviewing patient records for a sample of CPA/EE new users (n=200), the acne was recorded in 77% of women, hirsutism in 9.5% and polycystic ovary syndrome in 9.5%. Majority of CPA/EE users had a prior acne diagnosis and/or treatment, 76% (n=2091) in 2011, 79% (n=2296) in 2012 and 78% (n=1834) in 2014. Concomitant use of CPA/EE and another HC was rare, 1% of CPA/EE users in 2011 and fewer than 0.5% of CPA/EE users in both 2012 and 2014.
  
  
  CONCLUSIONS
  Before and after 2013, the majority of UK women starting treatment with CPA/EE had a condition in line with its approved indication and had received prior acne treatment as per guidance.
authors: Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain. Electronic address: luciaceife@gmail.com.
authors: Lucía
authors: L
authors: Cea Soriano
authors: Global Epidemiology, Bayer Pharma AG, Berlin, Germany.
authors: Alex
authors: A
authors: Asiimwe
authors: Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain.
authors: Luis A
authors: LA
authors: García Rodriguez
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D003277:Contraceptives, Oral, Combined; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D016208:Databases, Factual; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D058006:General Practice; D006628:Hirsutism / Q000188:drug therapy; D006801:Humans; D017588:Hyperandrogenism / Q000188:drug therapy; D056687:Off-Label Use / Q000706:statistics & numerical data*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; C032640:Cyproterone acetate, ethinyl estradiol drug combination
keywords: Acne; Contraception; Cyproterone acetate/ethinylestradiol; Database; Off-label; Prescribing