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COMMENTARY
Open Access

Extended Effectiveness of the Etonogestrel-Releasing Contraceptive Implant and the 20 µg Levonorgestrel-Releasing Intrauterine System for 2 Years Beyond U.S. Food and Drug Administration Product Labeling

Moazzam Ali, Luis Bahamondes and Sihem Bent Landoulsi
Global Health: Science and Practice December 2017, 5(4):534-539; https://doi.org/10.9745/GHSP-D-17-00296
Moazzam Ali
aDepartment of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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  • For correspondence: alimoa{at}who.int
Luis Bahamondes
bFamily Planning Clinic, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
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Sihem Bent Landoulsi
aDepartment of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Tables

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    TABLE 1.

    Pregnancy Data Among LNG- and ENG-Releasing Subdermal Implant Users Through 5 Years of Use From Ali et al., 201618

    LNG-Releasing ImplantENG-Releasing Implant
    Years 1–3aYear 4aYear 5Years 1–5 (Cumulative)Years 1–3aYear 4aYear 5Years 1–5 (Cumulative)
    No. of women997470330995311204
    Woman-months of observation286706,2544,62930,325287864,6062,45422,044
    No. of pregnancies3b0033b003
    Cumulative pregnancy rates per 100 woman-yearsc (95% CI)0.4 (0.1–1.4)0.8 (0.2, 2.3)0.4 (0.1–1.4)0.6 (0.2, 1.8)
    • Abbreviations: CI, confidence interval; ENG, etonogestrel; LNG, levonorgestrel.

    • ↵a Cut-off for 3 years was at 38 months post-insertion while year-4 data started at 36 months post-insertion, resulting in a 2-month overlap in data. Woman-months of observation between these 2 time periods, however, is not additive.

    • ↵b Pregnancy data from the first 3 years reported in Bahamondes et al., 2015.22

    • ↵c Kaplain-Meier rates.

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    TABLE 2.

    Pregnancy Data Among ENG-Releasing Implant Users Through 5 Years From McNicholas et al., 201717

    Year 4Year 5
    No. of women223102
    Woman-years of observation444.0
    No. of pregnancies00
    Pregnancy rate per 100 woman-years (1-sided 97.5% CI)0 (0, 1.48)0 (0, 2.65)
    • Abbreviations: CI, confidence interval; ENG, etonogestrel.

    • View popup
    TABLE 3.

    Comparative Efficacy of the TCu380A IUD and the 52-mg LNG IUS Over 7 Years From Rowe et al., 201623

    TCu380A IUDLNG IUS
    No. of women1,8711,884
    Woman-years of observation10,0887,903
    No. of pregnancies337a
    Cumulative pregnancy rate per 100 woman-years (95% CI)2.5 (2.1, 2.9)0.5 (0.3, 0.8)
    • Abbreviations: CI, confidence interval; IUD, intrauterine device; LNG IUS, levonorgestrel-releasing intrauterine system.

    • ↵a No pregnancies were reported in years 6 and 7.

    • View popup
    TABLE 4.

    Pregnancy Data Among Users of the 52-mg LNG IUS From McNicholas et al., 201717

    Year 6Year 7
    No. of women496
    Woman-years of observation696.9
    No. of pregnancies2
    Pregnancy rate per 100 woman-years (95% CI)0.25 (0.04, 1.42)0.43 (0.08, 2.39)
    • Abbreviations: CI, confidence interval; LNG IUS, levonorgestrel-releasing intrauterine system.

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Global Health: Science and Practice: 5 (4)
Global Health: Science and Practice
Vol. 5, No. 4
December 28, 2017
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Extended Effectiveness of the Etonogestrel-Releasing Contraceptive Implant and the 20 µg Levonorgestrel-Releasing Intrauterine System for 2 Years Beyond U.S. Food and Drug Administration Product Labeling
Moazzam Ali, Luis Bahamondes, Sihem Bent Landoulsi
Global Health: Science and Practice Dec 2017, 5 (4) 534-539; DOI: 10.9745/GHSP-D-17-00296

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Extended Effectiveness of the Etonogestrel-Releasing Contraceptive Implant and the 20 µg Levonorgestrel-Releasing Intrauterine System for 2 Years Beyond U.S. Food and Drug Administration Product Labeling
Moazzam Ali, Luis Bahamondes, Sihem Bent Landoulsi
Global Health: Science and Practice Dec 2017, 5 (4) 534-539; DOI: 10.9745/GHSP-D-17-00296
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  • Article
    • BACKGROUND
    • BRIEF DESCRIPTION OF HORMONAL LARCs
    • PHARMACOKINETIC DATA SUPPORT LONGER EFFICACY
    • CLINICAL STUDIES ALSO SUPPORT LONGER EFFICACY
    • IMPLICATIONS
    • Acknowledgments
    • Notes
    • REFERENCES
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