Third Generation Pills Linked to Blood Clots. Part 2
Posted By Clod on February 21, 2012
Algra and his colleagues decided to review 13 studies done on women who used the pill before October 1995, when the British Committee on Safety of Medicines announced there was a link. The announcement was followed by an upsurge in unplanned pregnancies and abortions.
Algra’s team reanalyzed the data and found that third generation oral contraceptives were linked to a 1.7-fold increased risk of venous thrombosis compared to second generation pills. The risk was highest in first time users of birth control pills and during the first year of third generation contraceptive use.
In real world terms, that means that while roughly 3 per 10,000 women taking second generation pills will develop blood clots, about 5 in 10,000 women on third generation pills will develop them. While the risk is small, says Algra, it could be reduced if women — especially first-time users of the pill — were prescribed a second-generation oral contraceptive.
Furthermore, they found that the biases that had been so vehemently debated in the previous studies were not responsible for the finding of increased risk.
Dr. Alexander Walker, a professor of epidemiology at the Harvard School of Public Health in Boston, says that while the risk isn’t dramatic, it’s something that doctors and patients should be aware of. “There aren’t any big red flags here, that one of these drugs is a disaster,” says Walker. “There’s a yellow light for some of them. It’s a reason to discuss it but not a reason to stop taking a pill if you’re on it.”
Algra says that he would tell a woman with concerns about oral contraceptives about this risk. “With regards to venous thrombosis, they [the third generation pills] are not safer,” says Algra. “If this was a woman who has never used the pill, I would say specifically with first-time users that the risk difference is even higher. I would recommend [that she] start with second generation pills.”
And if a woman now taking third generation pills has had no side effects with second generation pills, Algra says, “then I would recommend that she go back to the second generation pill. If she had side effects with the second generation pill, you might balance that against the risk increase for venous thrombosis with the third generation pill. “
Algra and his colleagues also broke down the research findings based on how the studies were funded. “There’s quite a difference between non-industry sponsored studies, which come up with a 2.3-fold increased risk for third generation pills, as opposed to the industry-sponsored studies, which come up with a 1.3-fold increased risk.”
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