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Blood, 1 February 2004, Vol. 103, No. 3, pp. 927-933. Prepublished online as a Blood First Edition Paper on October 9, 2003; DOI 10.1182/blood-2003-04-1285. This Article Full Text (PDF) Supplemental Tables All Versions of this Article: 2003-04-1285v1 103/3/927    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kemmeren, J. M Articles by Grobbee, D. E Search for Related Content PubMed PubMed Citation Articles by Kemmeren, J. M Articles by Grobbee, D. E Related Collections Related Letter in Blood Online Social Bookmarking                   What's this? Submitted April 24, 2003 Accepted September 16, 2003 Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor VLeiden mutation: a randomized trial Jeanet M Kemmeren, Ale Algra*, Joost C Meijers, Guido Tans, Bonno N Bouma, Joyce Curvers, Jan Rosing, and Diederick E Grobbee Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands * Corresponding author; email: A.Algra{at}neuro.azu.nl. A plausible mechanism to explain thrombotic risk differences associated with the use of second and third generation oral contraceptives (OC), particularly in carriers of factor VLeiden, is still lacking. In a double blind trial, 51 women without and 35 women with factor VLeiden were randomized to either a second (30 µg ethinylestradiol/150 µg levonorgestrel) or third generation (30 µg ethinylestradiol/150 µg desogestrel) OC. After two cycles of use and a wash-out of 2 cycles, the participants continued with the corresponding progestagen-only preparation. Hemostatic variables that probe the activity of the anticoagulant protein C system were determined. Compared with levonorgestrel, desogestrel-containing OC significantly decreased protein S and increased APC resistance in both groups. OC with desogestrel had the most pronounced effects in carriers of factor VLeiden. Progestagen-only preparations caused changes of anticoagulant parameters opposite to those of combined OC, which in a number of cases were more pronounced with levonorgestrel. Our data show that progestagens in combined OC counteract the thrombotic effect of the estrogen component. The higher thrombotic risk associated with third generation OC as compared to second generation OC may be explained by the fact that desogestrel appeared less antithrombotic than levonorgestrel, especially in women with factor VLeiden. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: Increased resistance to activated protein C in women taking third-generation oral contraceptives? Jean-Christophe Gris, Eva Nouvellon-Cochery, Pierre Marès, Jan Rosing, Guido Tans, Jeanet M. Kemmeren, Joost C. M. Meijers, Bonno N. Bouma, Joyce Curvers, Diederick E. Grobbee, and Ale Algra Blood 2004 104: 1907-1909. 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