Diane 35 and thrombosis risk – Zembla broadcast

The oral contraceptive pill ‘Diane 35- was’ in the news again. I wrote about the diane-35 pill on this website before, even twice,  when there was a broadcast of the radio show Argos.

The first time I wrote:

[…] this is a bit strange: there is nothing new about the information that third and fourth generation oral contraceptives have an increased risk of thrombosis compared to the risk conveyed by second generation oral contraceptives. Because the desired effects of the older and newer generation pills are similar (not getting pregnant, preventing or curing acne) there is limited, if any, reason to prescribe the newest and more expensive pills. See also the recent comment by Helmerhorst and Rosendaal in the BMJ. However, still 160.000+ (Diane 35) 500.000 (third generation) women take these newer pills. […]

Those words also fit the broadcast of the TV show Zembla last week. Zembla has a reputation to be ‘activist reporters’ and some of the broadcast is not to my taste. It is however good to see that Zembla tried to figure out how it is possible that Diane-35, which is not registered as an anti-conception pill, still gets prescribed as such. However, the broadcast leaves me unsatisfied for it does not provide answers, or even get to talk to everybody they wanted to? (Why did they reporters did not proceed to work on their WOB? a missed change!)

As in the previous two blog posts on this topic, I feel like these story are important but they also need to have the proper amount of nuance. Therefore, also this time I conclude with saying that the absolute risk of thrombosis in young women (both venous and arterial) is very low, even when using oral contraceptives. But all unnecessary risk without any benefit that can be avoided should be avoided. As always, consult your GP if you have any questions.

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Diane 35 and thrombosis risk – Argos broadcast part II

Last week I wrote a post after hearing the radio broadcast of Argos. They concluded that broadcast with the promise to discuss how it is possibe that a more expensive, just as effective medicine which has more side effects still can be prescribed (in large numbers) in the Netherlands.

So I’ve listen with great interest the second part of the story, which can be heard on the Argos website. They journalists did a good job by covering all sides of the story , and they provide insight in the differences between ‘advertisement’ and ‘providing information’. What if information that is provided is only one sided? Does that count as advertisement? and if you want to play a nice game during the broadcast, ‘spot the logical fallacy’ is good suggestion… Gems!

In case you are wondering: the absolute risk of thrombosis in young women is low, even when using oral contraceptives. But I still believe that all unnecessary added risk without any benefit that can be avoided should be avoided by you in dialogue with your GP!

Hora Est – thesis is topic of a Cicero article

cicero maart 2013The Cicero, the monthly magazine of the LUMC, wrote an article on my thesis. During the interview, I was able to bring fort the nuances of the work in the thesis. That is, my thesis does not fully provide all the answers in details for allr esearch questions but it does provide a simple overview: an increased clotting potential is a risk factor for ischaemic stroke but not for moycardial infarction. Unfortunately, space limitations dictated that some remarks had to be left out. Fortunately, the last remarks is about the relevance of teaching experience as a PhD: a great link to one of my propositions.

The picture above was placed in the Cicero to accompany the interview. I like it very much because it has a certain epidemiological feel to it: a group (a cohort?) of women all different, but with certain patterns.

The text of the interview can be downloaded from the media page, directly directly clicking here (pdf). The text can also be read online if you… Continue reading “Hora Est – thesis is topic of a Cicero article”

Diane 35 and thrombosis risk – Argos broadcast

The oral contraceptive pill – especially the Diane 35- was in the news again. However, this is a bit strange: there is nothing new about the information that third and fourth generation oral contraceptives have an increased risk of thrombosis compared to the risk conveyed by second generation oral contraceptives. Because the desired effects of the older and newer generation pills are similar (not getting pregnant, preventing or curing acne) there is limited, if any, reason to prescribe the newest and more expensive pills. See also the recent comment by Helmerhorst and Rosendaal in the BMJ. However, still 160.000+ (Diane 35) 500.000 (third generation) women take these newer pills. Since thrombosis risk might be highest in the first few months, it is unclear whether these women all should switch to the safer second generation oral contraceptives. But for women who get their first prescription, a second generation oral contraceptive the best way to go (also according the Dutch GP guidelines).

A lot of the research on this topic has been executed by my colleagues from both the MEGA study and the RATIO study. Want to learn more about the pill controversy, please listen this episode of Argos, a Dutch radio programme.

In case you are wondering: the absolute risk of thrombosis in young women is low, even when using a newer generation oral contraceptives. But all added risk that can be avoided should be avoided by you in dialogue with your GP!