Enhancement by @entity5337 mutation of risk of XXXX associated with oral contraceptives containing a third-generation progestagen.

@entity5337 @entity1 @entity2082 @entity6862 @entity49 @entity1150 @entity7281 @entity715 @entity7280
Recent concern about the safety of combined @entity7280 ( @entity6862 ) with third-generation progestagens prompted an examination of data from a population-based case-control study (Leiden @entity49 Study). We compared the risk of @entity1150 ( @entity1150 ) during use of the newest @entity6862 , containing a third-generation progestagen, with the risk of "older" products. We also investigated the influence of family history of @entity715 , previous pregnancy, age, and the thrombogenic @entity5337 mutation. We selected 126 @entity1 with @entity1150 and 159 controls aged 15-49 (mean age 34.9) and premenopausal and found, as compared with non-users, the highest age-adjusted relative risks to be that for an OC containing @entity7281 and 30 micrograms @entity2082 (relative risk [RR] 8.7, 95% CI 3.9-19.3). We found lower relative risks for all other types of OC, ranging from 2.2 to 3.8. In a direct comparison, users of the @entity7281 -containing oral contraceptive had a 2.5-fold higher risk (95% CI 1.2-5.2) than users of all other OC types combined. The relative risk for the @entity7281 -containing OC was similar among @entity1 with and without a family history--ie, preferential prescription because of family history cannot explain our findings. Nor could the excess risk be explained by previous pregnancy, and it was highest in the youngest age categories, where we would expect most new users. The age-adjusted RR for the @entity7281 -containing contraceptive was 9.2 (3.9-21.4) among non-carriers of the @entity5337 mutation and 6.0 (1.9-19.0) among carriers of the mutation. This latter risk is superimposed on the 8-fold increased risk of @entity49 for carriers of the @entity5337 mutation. The risk of carriers using the @entity7281 -containing OC as compared with noncarrier non-users will therefore be increased almost 50-fold. Use of low-dose @entity6862 with a third-generation progestagen carries a higher risk of @entity1150 than the previous generation of @entity6862 . The absolute risk of @entity1150 associated with these @entity6862 seems to be especially high among carriers of the @entity5337 mutation and among @entity1 with a family history of @entity715 . However, the higher risk associated with OC with a third-generation progestagen compared with previous generations was also present in @entity1 without @entity5337 and with no family history.
