| アブストラクト | OBJECTIVE: To estimate the effect of combined oral contraceptives (COCs) compared with non-estrogen-containing oral contraceptives on the risk of stroke among individuals with migraine with aura. METHODS: Using U.K. primary care medical records with linked hospital data from the Clinical Practice Research Datalink, the authors evaluated the risk of stroke associated with use of COCs, containing estrogen and progestogen, compared with progestogen-only pills (POPs) among individuals with migraine with aura. The study included individuals aged 15-49 years who initiated either contraceptive of interest from 2000 to 2024, with no history of stroke, other thrombotic disease, or menopause at the time of initiation. Risk of ischemic and any stroke was compared after application of treatment and censoring weights using risk differences and ratios from the Kaplan-Meier estimator. Individuals were censored on medication discontinuation in primary analyses. RESULTS: Among the 12,429 initiators of COCs and 41,984 initiators of POPs included in the study, 1-year risk of ischemic stroke was 17.36 and 17.62 per 100,000 people, respectively. After weighting, the 1-year risk difference for ischemic stroke for COCs compared with POPs was 9.53 per 100,000 people (95% CI, -38.65 to 57.71). For stroke of any type, the risk difference was 3.49 per 100,000 people (95% CI, -45.17 to 52.16). Effects were larger with shorter follow-up periods (3-month ischemic stroke risk difference of 17.62/100,000 people) but were still imprecisely measured. Findings were similar when individuals were not censored at medication discontinuation (ischemic stroke intent-to-treat risk difference of 10.36/100,000 people). CONCLUSION: The risk of stroke in this reproductive-age population of individuals with migraine with aura was low overall and similar between users of COCs and POPs. |
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| ジャーナル名 | Obstetrics and gynecology |
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| Pubmed追加日 | 2026/5/7 |
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| 投稿者 | Gibbs, Liza R; Fox, Matthew P; Aparicio, Hugo J; Jick, Susan |
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| 組織名 | Department of Epidemiology, Boston University School of Public Health, and the;Department of Neurology, Boston University Chobanian & Avedisian School of;Medicine, Boston, and the Boston Collaborative Drug Surveillance Program,;Lexington, Massachusetts; and Aetion, a Datavant Company, New York, New York. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42096712/ |
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