Will be jumping around this afternoon -- but starting off with "Hormonal Contraceptive Use and Association with Thromboembolism in Women with Sickle Cell Disease" with Dr. Natasha Bala. I feel like this is gonna be a good one! Tune in below. #ASH22 1/n
Combined OCPs is a category 2 -- meaning the benefit outweighs the risks. Their hypothesis was that risk of thrombosis was higher with combined OCPs versus progesterone only. #ASH22 2/n 
They excluded patients without Rx 6 months prior to include new hormonal agent patients only (and excluded ones that had a hx of VTE prior). Their definitions here. #ASH22 3/n
Here's what they found #SCD women were using. They found a total of 1.8% of VTE events in their patients = 21 events per 1000 person years (versus gen population of 0.5-1!!!) #ASH22 4/n
Patch was significantly HIGHER risk of VTE (versus oral combined pill). Know that this study was based on administrative claims so lots of caveats to this data. #ASH22 5/n
Q: mostly PE>DVT? how were these dx'd? Since it's administrative claims data so we can't tell what their sx. (It's based on ICD codes) #ASH22 6/6
Q: How does transdermal patches vs OCPs in non-SCD patients? A: in the literature, there is a 2x risk of thrombosis (about 60% higher estrogen exposure than pill users) due to its continuous delivery into the system. #ASH22
Q: What about low dose (<30 mcg) vs standard (>30 mcg) vs high dose estrogen? Also new vs older progestin? A: We are looking at that and will separate these out at publication. Looking forward to it. #ASH22
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