Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer

Detalhes bibliográficos
Autor(a) principal: Carneiro, Andrea Lucia Bastos
Data de Publicação: 2021
Outros Autores: Spadella, Ana Paula Curi, Souza, Fabiola Amaral de, Alves, Karen Borelli Ferreira, Araujo-Neto, Joaquim Teodoro de, Haidar, Mauro Abi, Dardes, Rita de Cássia de Maio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/191752
Resumo: OBJECTIVES: To compare the effects of low-dose conjugated estrogen (CE), raloxifene, and the combination thereof on the endometrium of postmenopausal women. METHODS: Postmenopausal women between 45 and 60 years of age, with Gail scoreX1.67 and no endometrial disorders, were randomly assigned to receive low-dose CE (0.3 mg), raloxifene (60 mg), or combined therapy for 1 year. Transvaginal ultrasound was performed at baseline and every 3 months; the Kupperman Index was assessed at baseline and every 6 months. Endometrial biopsies were performed if endometrial thickness (ET) was X5 mm or if vaginal bleeding occurred. The primary outcome was the occurrence of ETX5 mm over the one-year period. RESULTS: Seventy-three women were randomly assigned and analyzed on an intent-to-treat basis. Eight, three, and four women in the CE, raloxifene, and combination groups, respectively, exhibited ETX5 mm. No genital bleeding was reported in the combination group. Endometrial biopsy revealed atrophy or polyps in all groups, with one patient in the CE group exhibiting a proliferative endometrium without atypia. At 6 months, there was a progressive increase in mean ET in the CE group, but not in the other two groups, with statistically significant differences at 6, 9, and 12 months. Mean scores for vasomotor symptoms and Kupperman Index favored the CE and combination groups over raloxifene. CONCLUSION: Combined raloxifene and low-dose CE decreased the severity of menopausal symptoms to a similar extent as CE alone and had similar effects as raloxifene alone on the endometrium.
id USP-19_84f54920313a5a34d7681a8c017a7389
oai_identifier_str oai:revistas.usp.br:article/191752
network_acronym_str USP-19
network_name_str Clinics
repository_id_str
spelling Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast CancerSERMsEndometriumEstrogenRaloxifeneOBJECTIVES: To compare the effects of low-dose conjugated estrogen (CE), raloxifene, and the combination thereof on the endometrium of postmenopausal women. METHODS: Postmenopausal women between 45 and 60 years of age, with Gail scoreX1.67 and no endometrial disorders, were randomly assigned to receive low-dose CE (0.3 mg), raloxifene (60 mg), or combined therapy for 1 year. Transvaginal ultrasound was performed at baseline and every 3 months; the Kupperman Index was assessed at baseline and every 6 months. Endometrial biopsies were performed if endometrial thickness (ET) was X5 mm or if vaginal bleeding occurred. The primary outcome was the occurrence of ETX5 mm over the one-year period. RESULTS: Seventy-three women were randomly assigned and analyzed on an intent-to-treat basis. Eight, three, and four women in the CE, raloxifene, and combination groups, respectively, exhibited ETX5 mm. No genital bleeding was reported in the combination group. Endometrial biopsy revealed atrophy or polyps in all groups, with one patient in the CE group exhibiting a proliferative endometrium without atypia. At 6 months, there was a progressive increase in mean ET in the CE group, but not in the other two groups, with statistically significant differences at 6, 9, and 12 months. Mean scores for vasomotor symptoms and Kupperman Index favored the CE and combination groups over raloxifene. CONCLUSION: Combined raloxifene and low-dose CE decreased the severity of menopausal symptoms to a similar extent as CE alone and had similar effects as raloxifene alone on the endometrium.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2021-11-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/19175210.6061/clinics/2021/e2380Clinics; Vol. 76 (2021); e2380Clinics; v. 76 (2021); e2380Clinics; Vol. 76 (2021); e23801980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/191752/176651Copyright (c) 2021 Clinicsinfo:eu-repo/semantics/openAccessCarneiro, Andrea Lucia Bastos Spadella, Ana Paula Curi Souza, Fabiola Amaral de Alves, Karen Borelli Ferreira Araujo-Neto, Joaquim Teodoro de Haidar, Mauro Abi Dardes, Rita de Cássia de Maio 2023-07-06T13:04:01Zoai:revistas.usp.br:article/191752Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:04:01Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
title Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
spellingShingle Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
Carneiro, Andrea Lucia Bastos
SERMs
Endometrium
Estrogen
Raloxifene
title_short Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
title_full Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
title_fullStr Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
title_full_unstemmed Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
title_sort Effects of Raloxifene Combined with Low-dose Conjugated Estrogen on the Endometrium in Menopausal Women at High Risk for Breast Cancer
author Carneiro, Andrea Lucia Bastos
author_facet Carneiro, Andrea Lucia Bastos
Spadella, Ana Paula Curi
Souza, Fabiola Amaral de
Alves, Karen Borelli Ferreira
Araujo-Neto, Joaquim Teodoro de
Haidar, Mauro Abi
Dardes, Rita de Cássia de Maio
author_role author
author2 Spadella, Ana Paula Curi
Souza, Fabiola Amaral de
Alves, Karen Borelli Ferreira
Araujo-Neto, Joaquim Teodoro de
Haidar, Mauro Abi
Dardes, Rita de Cássia de Maio
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Carneiro, Andrea Lucia Bastos
Spadella, Ana Paula Curi
Souza, Fabiola Amaral de
Alves, Karen Borelli Ferreira
Araujo-Neto, Joaquim Teodoro de
Haidar, Mauro Abi
Dardes, Rita de Cássia de Maio
dc.subject.por.fl_str_mv SERMs
Endometrium
Estrogen
Raloxifene
topic SERMs
Endometrium
Estrogen
Raloxifene
description OBJECTIVES: To compare the effects of low-dose conjugated estrogen (CE), raloxifene, and the combination thereof on the endometrium of postmenopausal women. METHODS: Postmenopausal women between 45 and 60 years of age, with Gail scoreX1.67 and no endometrial disorders, were randomly assigned to receive low-dose CE (0.3 mg), raloxifene (60 mg), or combined therapy for 1 year. Transvaginal ultrasound was performed at baseline and every 3 months; the Kupperman Index was assessed at baseline and every 6 months. Endometrial biopsies were performed if endometrial thickness (ET) was X5 mm or if vaginal bleeding occurred. The primary outcome was the occurrence of ETX5 mm over the one-year period. RESULTS: Seventy-three women were randomly assigned and analyzed on an intent-to-treat basis. Eight, three, and four women in the CE, raloxifene, and combination groups, respectively, exhibited ETX5 mm. No genital bleeding was reported in the combination group. Endometrial biopsy revealed atrophy or polyps in all groups, with one patient in the CE group exhibiting a proliferative endometrium without atypia. At 6 months, there was a progressive increase in mean ET in the CE group, but not in the other two groups, with statistically significant differences at 6, 9, and 12 months. Mean scores for vasomotor symptoms and Kupperman Index favored the CE and combination groups over raloxifene. CONCLUSION: Combined raloxifene and low-dose CE decreased the severity of menopausal symptoms to a similar extent as CE alone and had similar effects as raloxifene alone on the endometrium.
publishDate 2021
dc.date.none.fl_str_mv 2021-11-09
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/191752
10.6061/clinics/2021/e2380
url https://www.revistas.usp.br/clinics/article/view/191752
identifier_str_mv 10.6061/clinics/2021/e2380
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/191752/176651
dc.rights.driver.fl_str_mv Copyright (c) 2021 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2021 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 76 (2021); e2380
Clinics; v. 76 (2021); e2380
Clinics; Vol. 76 (2021); e2380
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
_version_ 1800222765588938752