Table 3.
Oral Progestogen Exposure (Categorical) Modeled by Weighted Average Daily Dose.
| Progestogen | Dose Category | Recent Users* | Odds of VTE with Recent Progestogen Use Compared with Non-Recent Use of Any Progestogen | |
|---|---|---|---|---|
| No. (%) | Crude OR (99% CI)† | Adjusted OR (99% CI)‡ | ||
| NETA | Non-user | 124,392 (99.80) | Reference | Reference |
| Low (< 2.5 mg/d) | 58 (0.05) | 2.68 (1.32–5.47)‖ | 2.27 (1.04–4.97)§ | |
| Standard (2.5 to < 10 mg/d) | 152 (0.12) | 3.71 (2.43–5.67)‖ | 2.78 (1.69–4.57)‖ | |
| High (≥ 10 mg/d) | 34 (0.03) | 4.00 (1.64–9.74)‖ | 2.76 (0.98–7.81) | |
| MPA | Non-user | 124,392 (99.57) | Reference | Reference |
| Low (< 5 mg/d) | 342 (0.27) | 1.64 (1.18–2.27)‖ | 1.37 (0.95–1.98) | |
| Standard (5 to < 20 mg/d) | 169 (0.14) | 3.28 (2.18–4.92)‖ | 2.66 (1.67–4.26)‖ | |
| High (≥ 20mg/d) | 25 (0.02) | 4.00 (1.42–11.3)‖ | 2.27 (0.67–7.67) | |
| Prog | Non-user | 124,392 (99.72) | Reference | Reference |
| Low (< 50 mg/d) | 74 (0.06) | 1.52 (0.75–3.10) | 1.56 (0.71–3.46) | |
| Standard (50 to < 200 mg/d) | 217 (0.17) | 1.12 (0.71–1.76) | 0.92 (0.54–1.58) | |
| High (≥ 200 mg/d) | 60 (0.05) | 2.01 (0.96–4.21) | 1.54 (0.63–3.79) | |
| NET | Non-user | 124,392 (99.22) | Reference | Reference |
| Low (< 0.175 mg/d) | 107 (0.09) | 0.90 (0.45–1.80) | 0.50 (0.22–1.12) | |
| Standard (0.175 to < 0.7 mg/d) | 837 (0.67) | 0.94 (0.73–1.20) | 0.58 (0.44–0.77)‖ | |
| High (≥ 0.7 mg/d) | 22 (0.02) | 0.24 (0.02–3.40) | 0.31 (0.02–4.38) | |
NETA, oral norethindrone acetate; MPA, oral medroxyprogesterone acetate; Prog, oral progesterone; NET, oral norethindrone; VTE, venous thromboembolism; OR, odds ratio; CI, confidence interval; IQR, interquartile range.
Sample sizes were smaller than in binary progestogen exposure models due to additional exclusions for multiple progestogen use, missing dose information, or prescribed metric quantities less than 1 (NETA, n=124,636; MPA, n=124,928; Prog, n=124,743; NET, n=125,358).
Adjusted for year of birth and index date by study design.
Adjusted for year of birth and index date by study design and for 16 VTE risk factors: obesity, history of smoking, atherosclerotic cardiovascular disease, hypertension, congestive heart failure, chronic kidney disease, rheumatoid arthritis, systemic lupus erythematous, inflammatory bowel disease, cancer (with exclusions), hemiplegia or paraplegia, hypercoagulable state, superficial venous thrombosis, varicose veins, history of surgery or lower extremity fracture within 180 days before index date, and history of hospitalization within 180 days of index date.
P<.01
P<.001