Pulmonary vascular disease & thromboembolismCohort study
Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs: nationwide cohort study
- Nationwide cohort study
- national registries
Authors' conclusion
NSAID use was positively associated with the development of venous thromboembolism in women of reproductive age. The number of extra venous thromboembolic events with NSAID use compared with non-use was significantly larger with concomitant use of high/medium risk hormonal contraception compared with concomitant use of low/no risk hormonal contraception.
Study context
- Population
- Women aged 15–49 years living in Denmark 1996–2017 without prior thrombotic event, cancer, thrombophilia, hysterectomy, bilateral oophorectomy, sterilisation or infertility treatment8,710 VTE events
- Participants
- 2,029,065 women
- Exposure
- NSAID use vs non-use of non-steroidal anti-inflammatory drugs (NSAIDs), by hormonal contraception risk category
- Outcome
- First-time discharge diagnosis of lower limb DVT or PE
Main finding
As reported in the abstract
VTE, NSAID use vs non-use, by hormonal contraception
NSAID use vs Non-use of NSAIDsAdjusted incidence rate ratio (95% CI)
no hormonal contraception
7.2(6.0–8.5)
high risk hormonal contraception
11.0(9.6–12.6)
medium risk hormonal contraception
7.9(5.9–10.6)
low/no risk hormonal contraception
4.5(2.6–8.1)
Observational data: associations, not effects.
Further findings
| Outcome | extra events per 100 000 women (CI) |
|---|---|
| Extra VTE events per 100 000 women, by hormonal contraception · first week of NSAID treatment — NSAID use vs Non-use of NSAIDs · no hormonal contraception | 4 (3–5) |
| Extra VTE events per 100 000 women, by hormonal contraception · first week of NSAID treatment — NSAID use vs Non-use of NSAIDs · high risk hormonal contraception | 23 (19–27) |
| Extra VTE events per 100 000 women, by hormonal contraception · first week of NSAID treatment — NSAID use vs Non-use of NSAIDs · medium risk hormonal contraception | 11 (7–15) |
| Extra VTE events per 100 000 women, by hormonal contraception · first week of NSAID treatment — NSAID use vs Non-use of NSAIDs · low/no risk hormonal contraception | 3 (0–5) |
Original publication
Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs: nationwide cohort study. BMJ. Published 6 September 2023. doi:10.1136/bmj-2022-074450
Summarised from the published abstract; every number is checked against it