For Crohn's Disease Patients, Long-Term OC Use May Up Surgery Risk
(HealthDay News) — For females with Crohn's disease (CD), long-term use of oral contraceptives (OCs) is associated with increased risk of surgery, according to a study published in the June issue of Gastroenterology.
Hamed Khalili, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues conducted a prospective study of female patients with CD to examine how OC use contributes to progression of CD. Data were included for 4,036 patients with CD, with median follow-up of 58 months.
The researchers identified 482 incident cases of surgery. The multivariable-adjusted hazard ratios for surgery were 1.14 (95 percent confidence interval, 0.80 to 1.63) for past users and 1.30 (95 percent confidence interval, 0.89 to 1.92) for current users, compared with nonusers. Longer duration of use and higher prescribed daily dose correlated with increased risk of surgery (Ptrend = 0.036 and 0.016, respectively). The multivariable-adjusted hazard ratio for surgery was 1.68 (95 percent confidence interval, 1.06 to 2.67) for women with more than three years of OC use; the correlation was confined to the combination-type OC. One extra surgery was estimated to be necessary for every 83 patients with CD receiving the combination-type OC for at least one year.
"Clinicians [should carefully] evaluate and monitor contraceptive options among women with established CD," the authors write.
One author disclosed financial ties to the pharmaceutical industry.