AT ENDO 2015
SAN DIEGO – Hormone therapy in postmenopausal women does not seem to affect risk of mortality, results from a meta-analysis demonstrated.
“Most menopausal women suffer from a lot of bothersome symptoms, like hot flashes, sleep problems, and night sweats,” Dr. Khalid Benkhadra said during a press briefing at the meeting of the Endocrine Society. “Hormone therapy is usually very effective in alleviating these symptoms. However, women are usually concerned about the long-term safety [of HT].”
Doug Brunk/Frontline Medical News
Dr. Khalid Benkhadra
To assess all-cause and specific mortality associated with hormone therapy in postmenopausal women, Dr. Benkhadra and his associates searched databases for randomized trials published before August 2013 that compared hormone therapy with placebo or no treatment, with a follow-up of at least 6 months. The databases included MEDLINE and the Cochrane Central Register of Controlled Trials.
The outcome of interest was death from any cause, death from cardiac events, and death from breast cancer, lung cancer, ovarian cancer, colorectal cancer, and stroke.
The final meta-analysis included 43 clinical trials involving more than 52,000 women, mean age 62 years. Dr. Benkhadra, a research fellow at Mayo Clinic, Rochester, Minn., reported that no statistically significant association was observed between the use of hormone therapy and all-cause mortality (risk ratio, 0.99), with no significant interaction based on hormone type or preexisting heart disease. In addition, no association was observed between use of hormone therapy and death from myocardial infarction (RR, 1.04), stroke (RR, 1.49), and breast cancer (RR, 0.93), nor lung cancer, ovarian cancer, and colorectal cancer. “In each of these categories, there was no significant effect of HR on the risk of dying,” Dr. Benkhadra said. “Results were similar for estrogen only versus combined estrogen and progesterone therapy.”
He acknowledged certain limitations of the study, including the fact that the evidence in the 43 trials was rated as “low to moderate” and the length of follow-up was limited to 5 years.
Based on the findings, he concluded that postmenopausal women with bothersome symptoms “can engage with their physician in shared decision making to discuss treatment [with HT].”
Dr. Benkhadra reported having no relevant financial conflicts.
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