eprintid: 10137077 rev_number: 15 eprint_status: archive userid: 608 dir: disk0/10/13/70/77 datestamp: 2021-10-28 12:45:42 lastmod: 2022-08-18 15:17:37 status_changed: 2021-10-28 12:45:42 type: article metadata_visibility: show creators_name: Pasvol, TJ creators_name: Bloom, S creators_name: Segal, AW creators_name: Rait, G creators_name: Horsfall, L title: Use of contraceptives and risk of inflammatory bowel disease: A nested case–control study ispublished: inpress subjects: UCH divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G91 divisions: D12 divisions: G20 note: © 2021 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. abstract: Background: How contraceptive formulation, dose, duration of therapy and mode of delivery affects the risk of inflammatory bowel disease (IBD) is poorly described. // Aim: To examine associations between types of hormonal contraception and development of IBD. // Methods: This was a nested case–control study using IQVIA Medical Research Data. Women aged 15-49 years with a new diagnosis of IBD were matched with up to six controls by age, practice and year. Odds ratios (OR) and 95% confidence intervals (95% CI) for incident IBD and use of contraception were calculated. // Results: 4932 incident cases of IBD were matched to 29 340 controls. Use of combined oral contraceptive pills (COCPs) was associated with the development of Crohn's disease and ulcerative colitis (OR 1.60 [1.41-1.82] and 1.30 [1.15-1.45], respectively). Each additional month of COCP exposure per year of follow-up increased risk of Crohn's disease by 6.4% (5.1%-7.7%) and ulcerative colitis by 3.3% (2.1%-4.4%). Progestogen-only pills had no effect on Crohn's disease risk (OR 1.09 [0.84-1.40]) but there was a modest association with ulcerative colitis (OR 1.35 [1.12-1.64]). Parenteral contraception was not associated with the development of Crohn's disease or ulcerative colitis (OR 1.15 [0.99-1.47] and 1.17 [0.98-1.39], respectively). // Conclusions: We observed an increase in the risk of IBD with increasing duration of exposure to COCPs. Progestogen-only pills were not associated with Crohn's disease but there was a modest association with ulcerative colitis. There was no association between parenteral progestogen-only contraception and IBD. These findings are broadly consistent with a hypothesis that the oestrogen component of contraception may drive IBD pathogenesis. date: 2021-10-18 date_type: published official_url: https://doi.org/10.1111/apt.16647 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1894945 doi: 10.1111/apt.16647 lyricists_name: Bloom, Stuart lyricists_name: Horsfall, Laura lyricists_name: Pasvol, Thomas lyricists_name: Rait, Greta lyricists_name: Segal, Anthony lyricists_id: SBLOO26 lyricists_id: LJHOR45 lyricists_id: TPASV67 lyricists_id: GRAIT16 lyricists_id: AWSEG62 actors_name: Kalinowski, Damian actors_id: DKALI47 actors_role: owner full_text_status: public publication: Alimentary Pharmacology and Therapeutics citation: Pasvol, TJ; Bloom, S; Segal, AW; Rait, G; Horsfall, L; (2021) Use of contraceptives and risk of inflammatory bowel disease: A nested case–control study. Alimentary Pharmacology and Therapeutics 10.1111/apt.16647 <https://doi.org/10.1111/apt.16647>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10137077/1/Bloom_Use%20of%20contraceptives%20and%20risk%20of%20inflammatory%20bowel%20disease-%20A%20nested%20case%E2%80%93control%20study_AOP.pdf