Estradiol Valerate/Dienogest

In: Drugs · 2009 · vol. 69(12) , pp. 1635–1646 · doi:10.2165/11202820-000000000-00000 · PMID:19678714 · W2014431071
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Estradiol valerate/dienogest demonstrated contraceptive efficacy and acceptable cycle control in women aged 18-50 years with generally well-tolerated adverse events.

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This paper describes the clinical evaluation of estradiol valerate/dienogest, a four-phasic oral contraceptive combining estradiol and the 19-nortestosterone derivative dienogest, including contraceptive efficacy, bleeding pattern/cycle control, and tolerability. In a large non-comparative multicentre study of 1377 women (18–50 years), there were 13 pregnancies over 1797.5 women-years, giving an unadjusted Pearl Index of 0.73 (upper 95% CI 1.24) and an adjusted Pearl Index of 0.34 (upper 95% CI 0.73) after attributing six pregnancies to method failure. In a double-blind study of 798 women, it showed an acceptable bleeding pattern and cycle control compared with ethinylestradiol/levonorgestrel on co-primary endpoints. A key limitation explicitly noted is the pooled analysis’s exclusion of pregnancies occurring within 14 days of stopping therapy. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

- ▴ Estradiol valerate/dienogest is an oral contraceptive for women that combines the natural estrogen estradiol with the 19-nortestosterone derivative dienogest in a four-phasic formulation. - ▴ Estradiol valerate/dienogest demonstrated contraceptive efficacy in a large (n=1377), non-comparative, multicentre study in women aged 18–50 years, with 13 pregnancies over 1797.5 women-years of exposure generating an unadjusted Pearl Index (PI) of 0.73 (upper limit of 95% CI 1.24) [primary endpoint]. Six of the pregnancies were attributed to method failure, resulting in an adjusted PI, based on 1786.5 women-years of exposure, of 0.34 (upper limit of 95% CI 0.73). - ▴ In a double-blind study in 798 women aged 18–50 years, estradiol valerate/dienogest and ethinylestradiol/levonorgestrel demonstrated an acceptable bleeding pattern and level of cycle control, according to several co-primary endpoints. - ▴ As reported in the UK manufacturer’s summary of product characteristics, the unadjusted PI for women aged 18–35 years or 18–50 years in a pooled analysis of clinical studies was 1.01 (upper limit of 95% CI 1.59) and 0.79 (upper limit of 95% CI 1.23). This pooled analysis of three studies excluded those pregnancies occurring within 14 days of the cessation of therapy. - ▴ Estradiol valerate/dienogest was generally well tolerated in this population, with the nature of adverse events generally similar across the studies and between estradiol valerate/dienogest and ethinylestradiol/levonorgestrel. Similar content being viewed by others

References

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