Drospirenone improved bleeding profiles, lowered discontinuation rates compared with desogestrel
Regidor PA, Colli E, Palacios S. Overall and bleeding-related discontinuation rates of a new oral contraceptive containing 4 mg drospirenone only in a 24/4 regimen and comparison to 0.075 mg desogestrel. Gynecol Endocrinol. 2021;37:1121-1127.
A new POP, marketed under the name Slynd, recently came to market. It contains the progestin drospirenone (DRSP) 4 mg in a 24/4 regimen. This formulation has the advantage of being an antiandrogenic progestin, with a long enough half-life to allow for managing a missed pill in the same fashion as combined oral contraceptives (COCs).
Investigators in Europe conducted a double-blind, randomized trial to assess discontinuation rates due to adverse events (mainly bleeding disorders) in participants taking DRSP 4 mg in a 24/4 regimen compared with those taking the POP desogestrel (DSG) 0.075 mg, which is commonly used in Europe.4 Regidor and colleagues compared 858 women with 6,691 DRSP treatment cycles with 332 women with 2,487 DSG treatment cycles.
Top reasons for stopping a POP
The discontinuation rate for abnormal bleeding was 3.7% in the DRSP group versus 7.3% in the DSG group (55.7% lower). The most common reasons for stopping either POP formulation were vaginal bleeding and acne. Both of these adverse events were less common in the DRSP group. Pill discontinuation due to vaginal bleeding was 2.6% in the DRSP group versus 5.4% in the DSG group, while discontinuation due to acne occurred in 1% in the DRSP group versus 2.7% in the DSG group.
New oral contraception option
This study shows improved acceptability and bleeding profiles in women using this new DRSP contraception pill regimen.
WHAT THIS EVIDENCE MEANS FOR PRACTICE
Adherence to a contraceptive method is influenced by patient satisfaction, and this is particularly important in patients who cannot take COCs. It also should be noted that the discontinuation rate for DRSP as a POP used in this 24/4 regimen was similar to discontinuation rates for COCs containing 20 µg and 30 µg of ethinyl estradiol. Cost, however, may be an issue with DRSP, depending on a patient’s insurance coverage.
Adherence to a contraceptive method is influenced by patient satisfaction, and this is particularly important in patients who cannot take COCs. It also should be noted that the discontinuation rate for DRSP as a POP used in this 24/4 regimen was similar to discontinuation rates for COCs containing 20 µg and 30 µg of ethinyl estradiol. Cost, however, may be an issue with DRSP, depending on a patient’s insurance coverage.
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