Journal Club 12/02 Dr Stephen Newell. Current Problems in Pharmacovigilance October 2002 Safety update on long-term HRT. Coronary heart disease “The anticipated benefit of long-term use in preventing CHD, as suggested by observational studies, has not been supported by the RCT data.”.
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Journal Club 12/02
Dr Stephen Newell
Current Problems in Pharmacovigilance
Safety update on long-term HRT
Coronary heart disease
“The anticipated benefit of long-term use in preventing CHD, as suggested by observational studies, has not been supported by the RCT data.”
HRT and coronary heart disease in women:
a review of the evidence
Low AK, Russell LD, Holman HE, Shepherd JM, Hicks GS, Brown CA.
Am J Med Sci 2002 Oct;324(4):180-4
A study of HRT in postmenopausal women with ischaemic heart disease: the Papworth HRT atherosclerosis study
Clarke SC, Kelleher J, Lloyd-Jones H, Slack M, Schofield PM.
BJOG 2002 Sep;109(9):1056-62
“Overall results from RCTs have shown an increase in the risk of stroke in HRT users.”
“The absolute risk associated with HRT is…higher.”
Medical issues and hormone replacement therapy
Harris PF. Curr Womens Health Rep 2002 Oct;2(5):373-81
“The known increased risk of breast cancer in HRT users has been confirmed.”
HRT and breast cancer (from Bandolier)
“Results indicate a small increased risk of ovarian cancer in hysterectomised women with long-term use of oestrogen-only HRT.”
Does HRT increase the risk of ovarian cancer?
Indications for prescribing:
HRT and fracture risk (from Bandolier)
The randomised world is not without its imperfections: reflections on the Women's Health Initiative Study
McDonough PG. Fertil Steril 2002 Nov;78(5):951-6
symptoms of the menopause is not being contested.
Evidence from randomised trials on the
long-term effects of HRT
Beral V, Banks E, Reeves G. Lancet 2002 Sep 21;360(9337):942-4
Overall, HRT users had a significantly increased incidence of:
a significantly reduced incidence of:
but no significant change in: