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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Scoping review to map evidence on mechanism of action, pharmacokinetics, effectiveness and side effects of centchroman as a contraceptive pill
BMJ Open, Volume 9, No. 10, Article e030373, Year 2019
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Description
Objective To systematically identify and map the available evidence on effectiveness, side effects, pharmacokinetics and mechanism of action of centchroman as a contraceptive pill. Introduction Centchroman was introduced in the Indian national family planning programme in 2016 as a once-a-week short-term contraceptive pill/oral contraceptive. At present there are no WHO recommendations on this method of contraception. We examined the available evidence through a scoping review. Methods A search was conducted inclusive to the years 1970-2019 on electronic databases, grey literature sources and reference lists of included studies to identify studies. The five stages of Arksey and O'Malley's scoping review framework were applied in undertaking this scoping review. Results The review identified 33 studies conducted between 1976 and 2017. Two studies reported mechanism of action of centchroman. Pharmacokinetics was reported by five studies among non-breastfeeding women and four studies among breastfeeding women. Eight studies reported on effectiveness ranging from 93% to 100%. Pregnancies due to user failure ranged from 2.6% to 10.2%. Although side effects were reported in 13 studies, the incidence varied greatly between the studies. Continuous bleeding and prolonged cycles >45 days were the most commonly reported side effects. All studies conducted had a small sample size and the duration of follow-up of women was 12 months or less. Fifty-five per cent of studies were by the developers of the pill (Central Drug Research Institute) and results of the phase IV clinical trial were unavailable. Conclusions The scoping review shows that studies with robust designs and conducted in international context are lacking. Insufficient evidence exists on centchroman use as a postcoital contraceptive pill. The broad uncertainty in range of side effects and effectiveness in the studies implies insufficient evidence to make global recommendations on centchroman that is currently licensed as a contraceptive in India. © 2019 Author(s).
Authors & Co-Authors
Kabra, Rita
Switzerland, Geneva
Organisation Mondiale de la Santé
Allagh, Komal Preet
Switzerland, Geneva
Organisation Mondiale de la Santé
Ali, Moazzam Mirmohammad
Switzerland, Geneva
Organisation Mondiale de la Santé
Jayathilaka, Chandani Anoma
Switzerland, Geneva
Organisation Mondiale de la Santé
Mwinga, Kasonde
Switzerland, Geneva
Organisation Mondiale de la Santé
Kiarie, James Njogu
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 3
Authors: 6
Affiliations: 1
Identifiers
Doi:
10.1136/bmjopen-2019-030373
ISSN:
20446055
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Study Approach
Systematic review
Participants Gender
Female