Drospirenone vs Norethindrone for High Blood Pressure After Pre-eclampsia

Age: 18+
Sex: Female
Trial Phase: Phase 4
Sponsor: Oregon Health and Science University
Must be taking: Progestin-only pills
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether drospirenone, a newer progestin-only birth control pill, can better manage high blood pressure after childbirth compared to the standard norethindrone pill. The focus is on women who experienced preeclampsia, a pregnancy condition that causes high blood pressure. Participants will be divided into two groups: one taking drospirenone and the other taking norethindrone, for six weeks post-hospitalization. This trial may suit those who gave birth at Oregon Health & Science University and are considering a progestin-only birth control pill after preeclampsia. As a Phase 4 trial, this research involves an FDA-approved treatment and aims to understand its benefits for more patients.

What is the safety track record for these treatments?

Research has shown that drospirenone, a newer type of birth control pill, is generally well-tolerated. One study found that a birth control pill with drospirenone did not significantly affect blood pressure or heart health, suggesting it is safe to use. It might even help lower blood pressure, which could benefit those with high blood pressure after experiencing pre-eclampsia.

Norethindrone, another type of birth control pill, has been available for a long time. It is often recommended for new mothers, especially those who are breastfeeding. Norethindrone is widely used and has a strong safety record.

Both drospirenone and norethindrone have FDA approval for use as birth control, indicating they have undergone careful safety checks. However, individual reactions can vary, so discussing any concerns with a healthcare provider is important.12345

Why are researchers enthusiastic about this study treatment?

Drospirenone is unique because it not only serves as a progestin-only contraceptive, like norethindrone, but also has mineralocorticoid receptor activity, which can help lower blood pressure. This dual action makes it particularly promising for postpartum individuals who have experienced hypertensive disorders, such as pre-eclampsia. Researchers are excited about drospirenone because it could offer superior blood pressure management alongside contraception, addressing both reproductive and cardiovascular health needs simultaneously.

What evidence suggests that this trial's treatments could be effective for high blood pressure after pre-eclampsia?

This trial will compare Drospirenone and Norethindrone for managing high blood pressure after pre-eclampsia. Research has shown that Drospirenone, a type of birth control pill, can slightly lower blood pressure. Specifically, doses of 2 mg and 3 mg Drospirenone reduced the systolic blood pressure by 6.1 and 4.7 points, respectively. This finding is promising for individuals with high blood pressure after pre-eclampsia, as it might offer better control than other options.

Norethindrone, another birth control pill commonly used after childbirth, effectively prevents pregnancy but does not lower blood pressure like Drospirenone. This trial evaluates Drospirenone as a potentially better choice for managing blood pressure in this context.12678

Who Is on the Research Team?

JT

Julia Tasset

Principal Investigator

Oregon Health and Science University

Are You a Good Fit for This Trial?

This trial is for individuals who have had preeclampsia during pregnancy and are considering progestin-only pill contraception postpartum. They will be part of the study for 6 weeks after leaving the hospital.

Inclusion Criteria

Admission to Oregon Health & Science University following a birth (during the same admission)
Considering use of a progestin-only pill for postpartum contraception
I have been diagnosed with preeclampsia or chronic high blood pressure with worsening preeclampsia.

Exclusion Criteria

Planned use of a contraceptive method other than a progestin-only pill
I cannot take drospirenone or norethindrone due to health reasons.
I can't monitor my blood pressure at home after leaving the hospital.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants are randomized to receive either norethindrone or drospirenone for postpartum hypertension management

6 weeks
Weekly virtual check-ins via email

Follow-up

Participants are monitored for safety and effectiveness after treatment, with focus on blood pressure management

6 weeks
Weekly virtual surveys

Open-label extension (optional)

Participants may continue drospirenone after the trial with guidance on obtaining prescriptions

What Are the Treatments Tested in This Trial?

Interventions

  • Drospirenone
  • Norethindrone

Trial Overview

The trial compares two types of birth control pills, Norethindrone (0.35 MG) and Drospirenone, to manage high blood pressure after childbirth in patients with a history of preeclampsia.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Active Control

Group I: Postpartum DrospirenoneExperimental Treatment1 Intervention
Group II: Postpartum NorethindroneActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Oregon Health and Science University

Lead Sponsor

Trials
1,024
Recruited
7,420,000+

Citations

A Randomized Feasibility Trial Comparing Drospirenone ...

Drospirenone represents a novel therapeutic option that may offer superior blood pressure outcomes in postpartum individuals with hypertensive ...

Effects of a contraceptive containing drospirenone and ...

A contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone causes no significant changes in clinical and autonomic parameters.

Hypertension in Pregnancy and Postpartum - PubMed Central

In the CHAP trial, treating mild chronic hypertension resulted in a statistically significant reduction in the primary composite outcome (odds ratio [OR], 0.82 ...

Hypertension in women

Drospirenone 2 mg and 3 mg, but not 1 mg, in combination with estradiol significantly reduced 24 h systolic BP by 6.1 mm Hg and 4.7 mm Hg, ...

Past hormonal contraceptive use and pre-eclampsia ...

Conclusions This stud revealed that there was no significant association between past hormonal contraceptive use and preeclampsia except implant which was ...

Associations of periconceptional oral contraceptive use ...

Periconceptional OC use, particularly those containing oestrogen, was associated with increased risks of pre-eclampsia, pre-term birth, low birthweight and SGA.

Appendix D: Classifications for Combined Hormonal ...

Evidence: Women with a history of high blood pressure in pregnancy who also used COCs had a higher risk for myocardial infarction and VTE than ...

Postpartum contraception: A matter of guidelines - Grandi - 2024

WHO guidelines contraindicate combined hormonal contraceptives postpartum in breastfeeding patients between 6 weeks and 6 months after delivery.