Changes in the Use of Postmenopausal Hormone Therapy after the Publication of Clinical Trial Results

Haas, Jennifer S.; Kaplan, Celia P.; Gerstenberger, Eric; Kerlikowske, Karla

doi:10.7326/0003-4819-140-3-200402030-00009

Cited by 279 publications

(171 citation statements)

References 15 publications

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“…This percentage of current HRT users is somewhat higher than the 20% reported in 1999 in the general population in Great Britain, 43 but much lower than the estimated 41% of current users in a general population sample in the USA in 1997. 44 The combined number of current and past users in our sample (44%) is higher than in the USA sample of SCI women (35% preinjury and 26% postinjury), 40 but lower than the 60% reported in a 2002 British community survey of women aged 51-57 years. 45 The average duration of treatment in our sample was more than twice as long as in the general population, probably because almost half of the women on HRT in our study were taking it for osteoporosis prevention.…”

Section: Discussioncontrasting

confidence: 61%

“…It is worth noting that the data collection for this study took place before the latest results of the Women's Health Initiative 2 and Million Women Study 20 were published. The proportion of women who decide to start or continue HRT may have changed since then, both in the general population 44,46 and in women with SCI.…”

Section: Discussionmentioning

confidence: 99%

“…The main reasons for starting HRT were menopausal symptoms in 14 women (28%) and osteoporosis prevention in eight women (16%). The mean age when HRT was started was 48.8 years (range [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. Mean duration of treatment was 10.6 years in the 11 women still on HRT (range 6-15) and 7.2 years in the 11 women no longer on HRT (range 0.5-15).…”

Section: Hrt Usementioning

confidence: 99%

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Hormone replacement therapy in women with spinal cord injury – a survey with literature review

et al. 2004

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Study design: Postal questionnaire survey. Objective: To examine the current use of hormone replacement therapy (HRT) in a sample of menopausal women with spinal cord injury (SCI). Setting: National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, Aylesbury, UK. Method: A postal questionnaire was sent to 94 women from the NSIC patient database who met the study inclusion criteria (wheelchair dependent, aged 49 years and above, last seen or heard from within the last 3 years).Results: A total of 59 valid questionnaires were analysed. At the time of the survey, 50 women were menopausal and 11 of them were using HRT, six for menopausal symptoms and five for osteoporosis prevention. Another 11 had used HRT, eight for menopausal symptoms and three for osteoporosis prevention, but had discontinued it. The main reasons for stopping HRT were side effects. Of the 28 women who had never been on HRT, 20 had either enquired about it, or had been offered HRT, but decided against it. Of the nine women who were still premenopausal at the time of the survey, four would consider using HRT. Conclusions: Results show that 44% of the menopausal women in our sample have used HRT at some point and 22% still do, mostly for treatment of menopausal symptoms and for osteoporosis prevention. In view of the latest literature findings in able-bodied women, use of HRT for osteoporosis prevention in women with SCI may have to be reconsidered.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Hrt Usementioning

confidence: 99%

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Hormone replacement therapy in women with spinal cord injury – a survey with literature review

et al. 2004

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“…Although menopause hormonal therapy is the most effective treatment for vasomotor and urogenital symptoms, the results of the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) trials, which showed that the risks outweigh the benefits (3,4), dramatically altered the medical practices of such therapy (5). Despite a striking decrease in the use of menopause hormonal therapy, many women remain eligible for it.…”

Section: Systemic Lupus Erythematosus (Sle) Is An Autoimmune Disease mentioning

confidence: 99%

Menopause hormonal therapy in women with systemic lupus erythematosus

Sánchez‐Guerrero

González-Pérez

Durand-Carbajal

et al. 2007

Arthritis & Rheumatism

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Objective. To evaluate the effects of menopause hormonal therapy on disease activity in women with systemic lupus erythematosus (SLE).Methods. We conducted a double-blind, randomized clinical trial involving 106 women with SLE who were in the menopausal transition or in early or late postmenopause. Patients received a continuoussequential estrogen-progestogen regimen (n ‫؍‬ 52) or placebo (n ‫؍‬ 54). Disease activity was assessed at baseline and at 1, 2, 3, 6, 9, 12, 15, 18, 21, and 24 months, according to the SLE Disease Activity Index (SLEDAI). The primary outcome measure was global disease activity, estimated by measuring the area under the SLEDAI curve. Secondary outcome measures included maximum SLEDAI score, change in SLEDAI score, incidence of lupus flares, median time to flare, medication use, and adverse events. Results were studied using intent-totreat analysis.Results. At baseline, demographic and disease characteristics were similar in both groups. Mean ؎ SD SLEDAI scores were 3.5 ؎ 3.3 and 3.1 ؎ 3.4 in the menopause hormonal therapy and placebo groups, respectively (P ‫؍‬ 0.57). Disease activity remained mild and stable in both groups throughout the trial. There were no significant differences between the groups in global or maximum disease activity, incidence or probability of flares, or medication use. Median time to flare was 3 months in both groups. Thromboses occurred in 3 patients who received menopause hormonal therapy and in 1 patient who received placebo. One patient in each group died during the trial due to sepsis.Conclusion. Menopause hormonal therapy did not alter disease activity during 2 years of treatment. However, an apparently increased risk of thrombosis seems to be a real threat in women with SLE who receive menopausal hormone therapy.

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“…Because osteoporosis is a disease requiring long-term treatment if not prevented, women will likely need to be shifted from HT to other antiosteoporosis medications (AOMs) in order to continuously receive the beneficial effects of drug therapy on bone. Given the important therapeutic recommendations of the WHI publication and the documented impact of the study on HT use by several studies, [6][7][8][9][10][11] it is important to understand how these changes affect the management of osteoporosis in a vulnerable population, such as Medicaid recipients, with a lower socioeconomic status. The primary goal of this study was to evaluate the extent of osteoporosis prevention and treatment with AOM before and after release of the WHI results.…”

Section: Introduction Tmentioning

confidence: 99%

Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

Lee

Wutoh

Zhang

et al. 2006

Journal of Women's Health

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Objective: Publication of the Women's Health Initiative (WHI) study has changed our understanding on the effects of hormone replacement therapy. This study was designed to evaluate patterns of antiosteoporosis medication (AOM) use in a Medicaid population before and after the release of the WHI study results. Results: The overall prevalence of AOM did not change between pre-WHI and post-WHI study publication. However, there were significant changes in the prevalence of certain AOM drug classes. Estrogen use decreased significantly after the WHI study release for all age and racial groups. The prevalence for bisphosphonates and SERM increased significantly in the post-WHI period.Conclusions: The WHI study influenced patterns of use of all types of AOM, decreasing estrogen and increasing nonestrogen use among postmenopausal women in a Medicaid program. These results suggest that the WHI study affected patterns of use of bone protective pharmacotherapy, with a shift in bone protection therapy use from estrogen to nonestrogen AOMs. 155

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Changes in the Use of Postmenopausal Hormone Therapy after the Publication of Clinical Trial Results

Cited by 279 publications

References 15 publications

Hormone replacement therapy in women with spinal cord injury – a survey with literature review

Hormone replacement therapy in women with spinal cord injury – a survey with literature review

Menopause hormonal therapy in women with systemic lupus erythematosus

Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

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