Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new ortho-evra research articles will be listed here shortly after becoming available to us.
Related Sponsors
Medical research on ortho-evra
Knowledge and Beliefs about Contraception in Urban Latina Women.
J Community Health. 2008 May 23;
Venkat P, Masch R, Ng E, Cremer M, Richman S, Arslan A
Our study aimed to identify perceptions Latina women have about four different contraceptive methods and to investigate whether religiosity and acculturation play a role in their contraceptive choice. An observational cross-sectional study was performed at Bellevue Hospital. A questionnaire was given to women in the gynecology outpatient clinics asking about: oral contraceptive pills (OCP's), injectable contraception (DMPA), the Intrauterine device (IUD) and the Ortho-Evra Patch (Patch). In the 102 complete surveys, self identified Latina women were not convinced of the safety of OCPs and DMPA (less than 50% perceived them to be safe) and largely uncertain about the Patch and IUD. Latinas also demonstrated more negative beliefs about the side effects of OCPs and DMPA. In particular, they were concerned about weight gain, method reversibility, and bleeding. There was no substantial correlation between religiosity and contraceptive beliefs. Low level acculturated women were more likely to believe that the IUD and OCPs were harmful, as opposed to their more acculturated counterparts who demonstrated more negative beliefs about the Patch. Overall, Latina women in this study tended to overrate the risks associated with contraceptive use, particularly OCPs and DMPA. The markedly low method confidence suggested by high rates of "unsure" answers is a possible explanation for why Latinas are less adherent with birth control than their white counterparts.
Trends in prescribing patterns of hormonal contraceptives for adolescents.
Contraception. 2008 Apr; 77(4): 264-9
O'Brien SH, Kaizar EE, Gold MA, Kelleher KJ
BACKGROUND: Little is known regarding how prescribing patterns of hormonal contraceptives to adolescents in the United States have changed over time as new formulations become available and knowledge of thrombosis risk increases. Desogestrel and high-dose estrogen-containing formulations have been associated with a higher risk of thrombosis than other methods. STUDY DESIGN: We used the National Ambulatory Medical Care/National Hospital Ambulatory Medical Care surveys to describe trends in contraception prescriptions for 11- to 21-year-old females between 1993 and 2004. RESULTS: The majority of prescriptions arose from obstetrics/gynecology clinics. The proportion of desogestrel-containing prescriptions was approximately 10% throughout the study period. Ortho Evra (transdermal norelgestromin, ethinyl estradiol) and Yasmin (oral drospirenone, ethinyl estradiol) accounted for a steadily increasing proportion of prescriptions. CONCLUSION: With regard to contraception and thrombosis risk, a significant minority of adolescents are prescribed desogestrel-containing contraceptives, and a greater number are exposed to higher levels of estrogen from transdermal contraception. Future studies are needed to evaluate the absolute risk of thrombosis in adolescents using these formulations so clinicians have accurate safety information when prescribing to this unique population.
Transdermal hormonal contraception: benefits and risks.
Am J Obstet Gynecol. 2007 Aug; 197(2): 134.e1-6
Burkman RT
Transdermal drug delivery systems have been available in the United States for >20 years. Since the introduction of the first transdermal patch (scopolamine) for the treatment of motion sickness, >35 transdermal patch products have been approved by the US Food and Drug Administration for a variety of indications that include hormone replacement therapy, nicotine replacement therapy, chronic pain (fentanyl), angina (nitroglycerin), hypertension (clonidine), and more recently, overactive bladder (oxybutynin), and contraception (ethinyl estradiol/norelgestromin). Clinical data demonstrated the efficacy and safety of the contraceptive patch; however, concerns regarding estrogen levels and reports of venous thromboembolism led to the development of 2 epidemiologic studies and, subsequently, revised product labeling. Despite this, the contraceptive patch may be an appropriate option for some patients.
Clinical inquiries. What hormonal contraception is most effective for obese women?
J Fam Pract. 2007 Jun; 56(6): 471-3
Gordon L, Thakur N, Atlas M, Januchowski R
J Pediatr Adolesc Gynecol. 2007 Apr; 20(2): 61-5
Thurman AR, Hammond N, Brown HE, Roddy ME
STUDY OBJECTIVE: To prospectively evaluate the repeat teen pregnancy rates, within one year of delivery, among adolescents who choose the contraceptive patch (Ortho Evra) versus oral contraceptive pills (OCP) versus Depot Medroxyprogesterone Acetate (Depo Provera, DMPA) for postpartum contraception. DESIGN: Observational, prospective cohort study. Comparison groups are postpartum teens, who self-select the contraceptive patch (n = 55) versus DMPA (n = 142) versus OCPs (n = 55) immediately postpartum. SETTING: Medical University of South Carolina, a tertiary medical center. PARTICIPANTS: Postpartum teens, 11-19 years old; 72% were African American, and 96% qualified for Medicaid insurance. INTERVENTIONS: A structured telephone interview was performed every 3 months. MAIN OUTCOME MEASURES: The primary outcome measure was a repeat pregnancy within 12 months of the index delivery. Secondary outcome variables were contraceptive continuation rates, reasons for discontinuation, side effects and condom usage. RESULTS: At 1-year follow-up, repeat pregnancy rates were 14.2%, 29.7%, and 31.8% among DMPA, OCP, and patch users respectively (P = 0.02). DMPA users were significantly more likely to be using any form of hormonal contraception 1 year postpartum than patch or OCP users. Condom use was similarly low among all cohorts. CONCLUSION: Adolescents who choose DMPA for postpartum contraception are significantly less likely to become pregnant within 1 year of delivery, as compared to teens who choose OCPs or the patch.
J Control Release. 2007 Apr 2; 118(2): 196-203
Zurdo Schroeder I, Franke P, Schaefer UF, Lehr CM
Film forming polymeric solutions may present an alternative to the common transdermal dosage forms such as patches or gels. To evaluate the potential of these systems for transdermal drug delivery the permeation of ethinylestradiol from four formulations with different polymers was tested across heat separated human epidermis. The formulation with the best results was then modified by incorporating chemical enhancers to further increase the efficiency of the delivery system. Finally, drug delivery from the developed film forming systems was compared to a commercially available transdermal patch in vitro as well as in vivo in pigs. Among the tested preparations the formulation with polyurethane-14-AMP-acrylates copolymer (DynamX) showed the highest ethinylestradiol permeation. The drug transport was further increased with the incorporation of oleic acid as penetration enhancer, especially when used in combination with propylene glycol. The enhancing effect of oleic acid/propylene glycol was concentration-dependent and increased disproportionately with rising enhancer content. The film forming solution showed a higher ethinylestradiol permeation through heat separated human epidermis than the commercial EVRA patch in vitro and achieved measurable plasma concentrations of ethinylestradiol in vivo in pigs. These promising results encourage the further development of film forming polymeric solutions as novel transdermal dosage form.
Obstet Gynecol. 2007 Feb; 109(2 Pt 1): 339-46
Cole JA, Norman H, Doherty M, Walker AM
OBJECTIVE: To estimate the incidence of venous thromboembolism, acute myocardial infarction, and ischemic stroke among transdermal contraceptive system users compared with users of norgestimate-containing oral contraceptives with 35 mcg ethinyl estradiol. METHODS: We began with insurance claims data from UnitedHealthcare. We identified women exposed to the transdermal contraceptive system or norgestimate-containing oral contraceptives from April 2002 through December 2004. Outcomes were confirmed from medical records. We calculated incidence rates and age-adjusted incidence rate ratios. In a nested case-control analysis, we investigated and controlled for confounding. RESULTS: There were 49,048 woman-years of transdermal contraceptive system exposure and 202,344 woman-years of norgestimate-containing oral contraceptives exposure. There was a more than two-fold increase in the venous thromboembolism rate (incidence rate ratio 2.2, 95% confidence interval [CI] 1.3-3.8) among transdermal contraceptive system users (20 cases, 40.8 per 100,000 woman-years) compared with norgestimate-containing oral contraceptives users (37 cases, 18.3 per 100,000 woman-years). Acute myocardial infarction occurred in three transdermal contraceptive system users compared with seven among norgestimate-containing oral contraceptives users (incidence rate ratio 1.8, 95% CI 0.5-6.8). No strokes occurred among transdermal contraceptive system users, whereas 10 occurred among norgestimate-containing oral contraceptives users. In the nested case-control analysis, after exclusions for high-risk factors, the odds ratio for venous thromboembolism was 2.4 (95% CI 1.1-5.5). CONCLUSION: There was a more than two-fold increase in the risk of venous thromboembolism associated with use of the transdermal contraceptive system. Acute myocardial infarction and stroke occurred too rarely to ascertain precise risk estimates. LEVEL OF EVIDENCE: II.
The contraceptive patch in relation to ischemic stroke and acute myocardial infarction.
Pharmacotherapy. 2007 Feb; 27(2): 218-20
Jick SS, Jick H
STUDY OBJECTIVE: To compare rates of stroke and acute myocardial infarction in users of the Ortho EVRA contraceptive patch with these rates in users of norgestimate-containing oral contraceptives (OCs) with 35 microg of ethinyl estradiol. DESIGN: Retrospective, population-based, epidemiologic study. DATA SOURCE: PharMetrics database. SUBJECTS: Females aged 15-45 years in the PharMetrics database who had filled at least one prescription for the Ortho EVRA contraceptive patch or a norgestimate OC between April 1, 2002, and March 31, 2005. MEASUREMENTS AND MAIN RESULTS: Incidence rates and 95% confidence intervals (CI) were estimated for the outcomes of ischemic stroke and acute myocardial infarction by exposure. Crude incidence rates of ischemic stroke among users of the patch and users of norgestimate OCs were 13.6/100,000 woman-years (95% CI 5.9-26.8) and 11.3/100,000 woman-years (95% CI 5.4-20.8), respectively. The crude incidence rate of acute myocardial infarction was 1.7/100,000 woman-years (95% CI 0.04-9.5) in current patch users and 7.9/100,000 woman-years (95% CI 3.2-16.3) in current users of norgestimate OCs. Incidence rate ratios (IRRs) were estimated for the outcomes by comparing data for users of the patch and users of a norgestimate OC. The IRR for stroke was 1.2 (95% CI 0.41-3.4) and for acute myocardial infarction was 0.2 (95% CI 0.004-1.7). CONCLUSION: Ischemic stroke and acute myocardial infarction are rare among young women who use hormonal contraceptives, and the current data provide no suggestion of an increased risk of either ischemic stroke or acute myocardial infarction in users of the Ortho EVRA contraceptive patch compared with users of norgestimate OCs.
Comparing patient telephone callback rates for different hormonal birth control delivery systems.
Am J Ther. 2006 Nov-Dec; 13(6): 507-12
Victor I, Fink RA
This study was conducted to determine the number of office telephone callbacks in the first 3 months after initiating use of the vaginal ring, the transdermal patch, or an oral contraceptive. If a patient called back, the reason for her call was noted. Patients were prospectively followed from sites in New Jersey and Florida for 3 months after initiation of hormonal contraception (oral, transdermal, vaginal) and the number of callbacks for each method was assessed. Before study recruitment, the patients had either never used or discontinued hormonal contraception for at least 1 month. All patients were given standard counseling, which included reference handouts specific to their chosen form of contraception. The number of callbacks for patients on oral contraceptives was 30/96 (26 patients, 4 of the 26 with 2 callbacks each); for the transdermal patch, 20/40 (17 patients, 3 of the 17 with 2 callbacks each); and for the vaginal ring, 11/72 (11 patients). Pearson chi2 analysis revealed that all 3 groups were significantly different from each other (P = 0.0004). Most patients called back for side effects related to their method of choice, and some patients called back more than once. Rate of callbacks after initiation of hormonal contraception was the least with the vaginal ring. Use of oral contraception, often considered the gold standard, resulted in a callback rate that was midway between the number of callbacks for the vaginal ring and the number of callbacks for the transdermal patch. The lower observed rate of callbacks with the vaginal ring compared with oral and transdermal contraception may provide clinicians the confidence that this method is well tolerated by their patients.
Advances in hormonal contraception.
Adolesc Med Clin. 2006 Oct; 17(3): 653-71; abstract xi
Gupta N
This article presents a review of advances made in hormonal contraception over the past 15 years. It looks at the different routes of administration that have been developed, at newer formulations of conventional methods, and at novel contraceptive agents that are in the process of approval. The article provides a short description of each of these contraceptive methods, information about compliance, side effects, and efficacy, and an update on that particular method.