• 1. Jiangsu Institute of Planned Parenthood Research, State Contraceptives Adverse Reaction Surveillance Center, Nanjing 210036, P.R.China;
  • 2. School of Public health, Nanjing Medical University, Nanjing 211166, P.R.China;
  • 3. Department of Information Technology, Nanjing Medical University Library, Nanjing 210029, P.R.China;
ZHANG Xuening, Email: jasonzxn@126.com; SUN Zhiming, Email: 109616029@qq.com
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Objective To systematically review the efficacy of 10 commonly used intrauterine devices (IUD) by network meta-analysis.Methods PubMed, The Cochrane Library, EMbase, Web of Science, POPLINE, CNKI, WanFang Data, SinoMed, CMCI, ChiCTR databases and websites were electronically searched to collect randomized clinical trials (RCTs) on efficacy of 10 IUDs from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using WinBUGS 1.4.3 software and Stata 13.0 software.Results A total of 67 RCTs involving 59 991 IUD users were included. The results of network meta-analysis indicated that after 1 year of use, GyneFix had a lower pregnancy rate than those of TCu220C, TCu380A, YCu300, OCu165 and MLCu375, and its effectiveness ranked second out of ten IUDs (SUCRA=77.1%). YCu200 had a lower pregnancy rate than that of TCu220C, which ranked third (SUCRA=71.5%). After 2 years of use, GyneFix had a lower pregnancy rate than those of TCu220C, TCu380A and OCu165, which had the highest probability to be the most effective intervention (SUCRA=92.1%). YCu200 had a lower pregnancy rate than those of TCu220C, TCu380A, YCu300, OCu165, GCu200, GammaCu and MLCu375, and its effectiveness ranked second (SUCRA=81.2%).Conclusions Current evidence shows that the risk of pregnancy of GyneFix and YCu200 are lower at 1 and 2 years of use, which suggests they possess superior short-term effectiveness. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation: SHI Wenhui, ZHANG Xuening, WANG Guanrong, SUN Zhiming, ZHOU Jian, BA Lei, YANG Yuehua, LIN Jie, ZHANG Min, CHEN Ying, TAN Xiaoyan, TANG Shaowen, SUN Daquan. Efficacy of 10 common used intrauterine devices: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(2): 168-178. doi: 10.7507/1672-2531.202008011 Copy

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