Safety and Efficacy of Combined Oral Contraceptive Ethinyl Estradiol/Drospirenone (YAZ) in Chinese Women: A Single-Arm, Open-Label, Multicenter, Post-Authorization Study

Continuous wavelet transform and integration of discrete wavelet transform with principal component analysis and fuzzy inference system for the simultaneous determination of ethinyl estradiol and drospirenone in combined oral contraceptives

In this study, the spectrophotometric method integrated with continuous wavelet transform (CWT) and coupled discrete wavelet transform (DWT) with fuzzy inference system (FIS) was developed for the simultaneous determination of ethinyl estradiol (EE) and drospirenone (DP) in combined oral contraceptives (COCs). The CWT approach was performed in the linearity range of 0.6-6 µg/mL for EE and 0.9 to 18 µg/mL for DP. Biorthogonal with an order of 1.3 (bior1.3) at a wavelength of 216 nm and Daubechies with an order of 2 (db2) at a wavelength of 278 nm were selected as the best wavelet families for obtaining the best zero crossing point for EE and DP, respectively. The limit of detection (LOD) of 0.7677 and 0.3222 µg/mL and the limit of quantification (LOQ) of 2.326 and 0.9765 µg/mL were obtained for EE and DP, respectively. The mean recovery of 103.24% and 99.77%, as well as root mean square error (RMSE) of 0.1896 and 0.1969, were found for EE and DP, respectively. In the DWT, the absorption of the mixtures was decomposed using different wavelets named db4, db2, Symlet2 (sym2), and bior1.3. Each of the wavelet outputs was dimension reduced by the principal component analysis (PCA) method and considered as FIS input. The wavelet of db4 with the coefficient of determination (R2) of 0.9979, RMSE of 0.0968, and mean recovery of 100.63% was chosen as the best one for the EE, while bior1.3 with R2 of 0.9955, RMSE of 0.4055, and mean recovery of 101.93% was selected for DP. These methods were successfully used to analyze the EE and DP simultaneously in tablet pharmaceutical formulation without any separation step. The suggested methods were compared with a reference method (HPLC) using analysis of variance (ANOVA) at a 95% confidence level, and no significant difference was observed in terms of accuracy. The suggested chemometric methods are reliable, rapid, and inexpensive, and can be used as an environmentally friendly alternative to HPLC for the simultaneous estimation of the mentioned drugs in commercial pharmaceutical products.

Effect and safety of drospirenone and ethinylestradiol tablets (II) for dysmenorrhea: A systematic review and meta-analysis

Aim

This systematic review aimed to assess the efficacy and safety of Drospirenone and Ethinylestradiol Tablets (II) in the treatment of dysmenorrhea.

Methods

Electronic databases, namely PubMed, Embase, Cochrane Controlled Register of Trials (CENTRAL), Scopus, Science, CBM, CNKI, Wanfang, and VIP, were searched before September 2022. Randomized controlled trials (RCTs), non-randomized controlled trials, cohort studies, case-control studies, and single-arm studies were included. Furthermore, the Cochrane Risk of Bias Tool for Systematic Reviews version 1 was used for the risk of bias assessment on RCTs. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used for risk of bias assessment on non-randomized studies. The risk ratio (RR) was calculated for dichotomous data. Mean difference (MD) or standardized MD (SMD) were used as the effect size for continuous data.

Results

A total of 11 studies involving 2,251 participants with dysmenorrhea were included. When Drospirenone and Ethinylestradiol Tablets (II) conventional 24/4-day regimen was compared with placebo, the total efficiency rate (defined as pain symptom disappearing or being relieved) in Drospirenone and Ethinylestradiol Tablets (II) 24/4-day regimen group was higher than in placebo group (RR = 5.55, 95%CI: 2.48-12.39, P < 0.0001). No clear differences were found on risk of overall adverse events or specific adverse events. When Drospirenone and Ethinylestradiol Tablets (II) was compared with active control drugs, no clear differences were found on the total efficiency rate or visual analog scale (VAS) scores for dysmenorrhea and other related pain. The risk of overall adverse events decreased in Drospirenone and Ethinylestradiol Tablets (II) conventional 24/4-day regimen (13/53 vs. 66/148, RR = 0.55, 95%CI: 0.33-0.91) when compared with active control drugs group. When Drospirenone and Ethinylestradiol Tablets (II) flexible extended regimen was compared with conventional 24/4-day regimen, the number of days of dysmenorrhea (MD=-3.98, 95%CI: -5.69 to -2.27), and dysmenorrhea associated with unscheduled bleedings (MD = -1.6, 95%CI: -2.8 to -0.5), were fewer in flexible extended regimen. In addition, there were no differences found on risk of adverse events (including mood changes, spotting, headache, breast pain, nausea, and vomiting) between compared groups (P > 0.05).

Conclusion

Drospirenone and Ethinylestradiol Tablets (II) could improve symptoms of dysmenorrhea and decrease other related pain symptoms. More high-quality evidence is needed to confirm the advantages.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021271605], identifier [CRD42021271605].

Association between Oral Contraceptive Use and the High-Sensitivity C-Reactive Protein Level in Premenopausal Korean Women

Although oral contraceptives (OCs) are widely used, few national epidemiological studies have evaluated the association between OC use and serum high-sensitivity C-reactive protein (hs-CRP) levels in Korean women. This population-based cross-sectional study was conducted with data from the 2015–2018 National Health and Nutrition Examination Survey. In the sample of 5332 premenopausal women aged ≥19 years, hs-CRP concentrations were 1.087 mg/L among OC users and 0.953 mg/L among OC non-users. After adjustment for confounders, OC users had an increased likelihood of having risky (>1.0 mg/L) hs-CRP levels (adjusted odds ratio (aOR) = 1.58; 95% confidence interval (CI), 1.25–1.98) compared with OC non-users. In addition, the aOR for high-risk (>3.0 mg/L) hs-CRP levels in OC users compared with non-users was 1.51 (95% CI, 1.06–2.16). These findings demonstrate that OC use alters the concentration of hs-CRP, a biomarker of chronic low-grade inflammation, and suggest that long-term OC use is a risk factor in the pathogenesis of inflammatory diseases, including cardiovascular diseases.

Wearable Devices and Intelligent Application in Women's Postpartum Repair for Smart Healthcare

Wearable devices are more and more widely used in the field of smart healthcare. The purpose of this study was to explore the effect of contraceptive counseling and education on contraceptive behavior of women after induced abortion. The investigators will explain the situation of this topic to the respondents and select the respondents in strict accordance with the framework requirements of sampling design. All the data are from the induced abortion women in the first-, second-, and third-level hospitals, which reduces the selection bias of the respondents. It is found that the proportion of induced abortion among college students is the highest, reaching 66.03%. This study is helpful to reduce the incidence of unwanted pregnancy, induced abortion, and repeated abortion and improve the reproductive health of women.