Prescribing of cyproterone acetate/ethinylestradiol in UK general practice: a retrospective descriptive study using The Health Improvement Network

• Published in: Contraception (Stoneham) 2017-03, Vol.95 (3), p.299-305
• Main Authors: Cea Soriano, Lucía, Asiimwe, Alex, García Rodriguez, Luis A
• Format: Article
• Language: English
• Subjects: Acne; Acne Vulgaris - drug therapy; Adolescent; Adult; Androgen Antagonists - therapeutic use; Contraception; Contraceptives, Oral, Combined; Cyproterone Acetate - therapeutic use; Cyproterone acetate/ethinylestradiol; Databases, Factual; Drug Combinations; Ethinyl Estradiol - therapeutic use; Female; General Practice; Hirsutism - drug therapy; Humans; Hyperandrogenism - drug therapy; Obstetrics and Gynecology; Off-label; Off-Label Use - statistics & numerical data; Polycystic Ovary Syndrome - drug therapy; Prescribing; Retrospective Studies; United Kingdom; Young Adult
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2016.10.003

Abstract Objective To investigate prescribing patterns of cyproterone acetate/ethinylestradiol (CPA/EE) in the United Kingdom before and after the 2013 prescribing guidance. Study design We conducted a retrospective descriptive study in UK general practice. The study population included women with a first prescription (index date) for CPA/EE in The Health Improvement Network in 2011 ( N =2760), 2012 ( N =2923) and 2014 ( N =2341). We evaluated the proportion of new CPA/EE users with (i) a diagnosis of a hyperandrogenic condition, menstrual problem, consultation for contraception management, and other acne treatment, in the year before the index date; and (ii) proportion of new CPA/EE users with concomitant use of another hormonal contraceptive (HC). Results The percentage of CPA/EE new users with a record of a hyperandrogenic condition was 61% in 2011, 62% in 2012 and 63% in 2014. Corresponding percentages for acne were 51%, 54% and 55%, respectively. When manually reviewing patient records for a sample of CPA/EE new users ( n =200), the acne was recorded in 77% of women, hirsutism in 9.5% and polycystic ovary syndrome in 9.5%. Majority of CPA/EE users had a prior acne diagnosis and/or treatment, 76% ( n =2091) in 2011, 79% ( n =2296) in 2012 and 78% ( n =1834) in 2014. Concomitant use of CPA/EE and another HC was rare, 1% of CPA/EE users in 2011 and fewer than 0.5% of CPA/EE users in both 2012 and 2014. Conclusions Before and after 2013, the majority of UK women starting treatment with CPA/EE had a condition in line with its approved indication and had received prior acne treatment as per guidance.