Безопасностьометрия при непрерывной заместительной гормональной терапии 17b-эстрадиоло-эндопротезной заместительной гормональной терапии 17b-эстрадиолиин иниситисинисисиной

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The aim of the study was to determine the endometrial safety of oral 17/3- oestradiol combined continuously with dydrogesterone in preventing endometrial proliferation. The low dose group comprised three 52-week (13 cycles of 28 days) studies (two of which were double blind) using a 17ft- о estradiol dose of 1 mg daily combined with dydrogesterone 2,5; 5; 10 or 20 mg daily. The high dose group comprised two 24-week double-blind studies using a 17ft-oestradiol dose of 2 mg daily combined with dydrogesterone 2,5; 5; 10 or 15 mg daily. Endometrial safety was verified by aspiration endometrial biopsies. Inadequate progestational response was defined as proliferative endometrium, endometrial polyp, hyperplasia and carcinoma. Endometrial protection was achieved with dydrogesterone at doses of 5 mg or higher combined with 1 or 2 mg 17^-oestradiol. So, 5 mg daily dydrogesterone appears to be the lowest effective dose to ensure endometrial safety in a continuous combined regimen with 1 or 2 mg 17p-oestradiol.

Full Text

Restricted Access

About the authors

C. Bergeron

Laboratoire Pasteur-Cerba

Author for correspondence.
Email: info@eco-vector.com
Canada, France

A. Ferenczy

Laboratoire Pasteur-Cerba

Email: info@eco-vector.com
Canada, France

References

  1. Brinton L. A., Hoover R. N. Estrogen replacement therapy and endometrial cancer risk: unresolved issues // Obstet. Gynecol. — 1993. — Vol. 81.-P. 265-271.
  2. Shapiro S., Kelly J. P, Rosenberg L., et al. Risk of localised and widespread endometrial cancer in relation to recent and discontinued use of conjugated estrogens //New Engl. J. Med. - 1985. - Vol. 313. - P. 969-972.
  3. Grady D., GebretsadikT., Kerlikowske K., et al. Hormone replacement therapy and endometrial cancer risk: a meta-analysis // Obstet. Gynecol. — 1995. — Vol. 85. - P. 304-313.
  4. WhiteheadM. I., FraserD. The effects of estrogens and progestogens on the endometrium // Obstet. Gynecol. Clin. North. Am. — 1987. - Vol. 14. - P. 299-320.
  5. Varma T. R. Effect of long-term therapy with estrogen and progesterone on the endometrium of post-menopausal women // Acta Obstet. Gynecol. Scand. — 1985. — Vol. 64. - P. 41-46.
  6. Voigt L. R, Weiss N. S., Chur J., et al. Progestogen supplementation of exogenous oestrogens and risk of endometrial cancer//Lancet. — 1991. — Vol. 338. - P. 274-277.
  7. Vermorken A. J. M., Sultan С. H., Goos С. M. A. A. Dydrogesterone has no peripheral (anti)-androgenic properties // In Vivo. — 1987. — Vol. 1. - P. 167-172.
  8. Ottosson U. B., Johansson B. G., vonSchoultz B. Subtractions of high- density lipoprotein cholesterol during estrogen replacement therapy: a comparison between progestogens and natural progesterone //Am. J. Obstet. Gynecol. — 1985. — Vol. 115. - P. 746-750.
  9. Lacey R. W., Howson G. L., Sampson G. A. Safety of progestins: effects of dydrogesterone on blood lipids//Вr. J. Clin. Pract. — 1983. — Suppl. 24. -P. 4-10.
  10. Martin A. I. Progestins: a review of safety and tolerance in long-term administration // Modern Med. — 1986. - Vol. 31.-P. 1-7.
  11. Gambrell R. D., Bagnell C. A., Greenblatt R. B. Role of estrogens and progesterone in the etiology and prevention of endometrial cancer // Am. J. Obstet. Gynecol. — 1983. — Vol. 146. - P. 696-707.
  12. Lane G., Siddle N. C., Ryder T. A., etal. Effect of dydrogesterone on the 81
  13. oestrogenized postmenopausal endometrium // Br. J. Obstet.
  14. Gynaecol. — 1986. — Vol. 93. — P. 55-62.
  15. Lane G., Siddle N. C, Ryder T. A., et al. Endometrial responses, sideeffects and bleeding patterns in postmenopausal women using various doses of dydrogesterone in combination with conjugated oestrogens // Br. J. Clin. Pract. — 1983. - Vol. 24. - P. 23-26.
  16. Burch D. J., SpowartK. J. M., JessingerD. K, etal. A dose-ranging study of the use of cyclical dydrogesterone with continuous 17ft- oestradiol // Br. J. Obstet. Gynaecol. - 1995. - Vol. 102. - P. 243-248.
  17. Committee for Proprietary Medicinal Products (CPMP). Points to consider on Hormone Replacement Therapy. — London, 19 November 1997.
  18. Voetberg G. A., NetelenbosJ. C, Kenemans P, etal. Estrogen replacement therapy continuously combined with four different dosages of dydrogesterone: effect on calcium and lipid metabolism //J. Clin.Endocrinol. Metab. — 1994. — Vol. 79. - P. 1465-1469.
  19. Mijatovic V., Kenemans P, NetelenbosJ. C., etal. Oral 17ft- estradiol continuously combined with dydrogesterone lowers serum lipoprotein(a) concentrations in healthy postmenopausal women //J. Clin. Endocrinol. Metab. — 1997. — Vol. 82. - P. 3543-3547.
  20. Kurman R. J., Mazur M. T. Benign diseases of the endometrium // Kurman R. J. (ed.) Blaustein’s pathology of the female genital tract. — Berlin: Springer, 1994. — P. 367- 409.
  21. Wolfe S. A., Mackles A. Malignant lesions arising from benign endometrial polyps // Obstet.Gynecol. — 1962. — Vol. 20. — P. 542-550.
  22. Mittal K, Schwartz L., Goswami S., Demopoulos R. Estrogen and progesterone receptor expression in endometrial polyps // Int. J. Gynecol. Pathol. — 1996. — Vol. 15. - P. 345-348.
  23. Woodruff J. D., PickarJ. H. Incidence of endometrial hyperplasia in postmenopausal women taking conjugated estrogens (Premarin) with medroxyprogesterone acetate or conjugated estrogens alone // Am. J. Obstet. Gynecol. — 1994. — Vol. 170. - P. 1213-1223.
  24. The Writing Group for the PEP! trial. Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The postmenopausal estrogen/ progestin intervention trial// JAMA. — 1996. — Vol. 275. - P. 370-375.
  25. Van der Mooren M. J., HanselaarA. G., Born G. F., Rolland R. Changes in the withdrawal bleeding pattern and endometrial histology during 17/3-oestradiol- dydrogesterone therapy in postmenopausal women: a 2-year prospective study//Maturitas. — 1994. - Vol. 20. - P. 175-80.
  26. Ferenczy A., Gelfand M. M. Endometrial histology and bleeding patterns in post-menopausal women taking sequential, combined estradiol and dydrogesterone // Maturitas. — 1997. - Vol. 26. - P. 219-226.
  27. Cushing K. L, Weiss N. S., Voigt L. F, etal. Risk of endometrial cancer in relation to use of low-dose, unopposed estrogens // Obstet. Gynecol. - 1998. - Vol. 91. - P. 35-39.
  28. Comerci J. T., Fields A. L., Runowicz C. D., Goldberg G. L. Continuous low-dose combined hormone replacement therapy and the risk of endometrial cancer// Gynecol. Oncol. — 1997. — Vol. 64. — P. 425-430.
  29. Weiderpass E., Adami H. O., Baron J. A., et al. Risk of endometrial cancer following estrogen replacement with and without progestins // J. Natl. Cancer Inst. — 1999. - Vol. 91.-P. 1131-1137

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Структура проведенных исследований

Download (73KB)
Indexing metadata

Copyright (c) 2021 Eсо-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 66759 от 08.08.2016 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия Эл № 77 - 6389 от 15.07.2002 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies