Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial. Italian Chemoprevention Group.
Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial. Italian Chemoprevention Group.
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在一项预防试验中，他莫昔芬和透皮激素替代疗法对心血管危险因素的影响。
DOI：
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发表时间：
1998
影响因子：
8.8
通讯作者：
on behalf of the Italian Chemoprevention Group
中科院分区：
文献类型：
--
作者：
A. Decensi;C. Robertson;N. Rotmensz;G. Severi;P. Maisonneuve;V. Sacchini;P. Boyle;A. Costa;U. Veronesi;on behalf of the Italian Chemoprevention Group
他莫昔芬和经皮激素替代疗法（HRT）的组合可能会降低任何一种药物的风险和副作用，但不良相互作用可能会减弱其有益效果。我们在他莫昔芬的预防试验中评估了它们的组合对心血管危险因素的影响。基线和12个月的总，低密度脂蛋白（LDL）和高密度脂蛋白（HDL）-胆固醇，血小板和白色血细胞的测量结果在以下四组中获得：他莫昔芬（n = 1117），安慰剂（n = 1112），他莫昔芬和HRT（n = 68），安慰剂和HRT（n = 87）。该分析进一步扩展到随机分组时接受HRT但在12个月干预期间停止HRT的女性（他莫昔芬组n = 33，安慰剂组n = 35）和未接受HRT但在干预期间开始HRT的女性（研究的两组n = 36）。与安慰剂组的微小变化相比，他莫昔芬与持续HRT使用者的总胆固醇、LDL-胆固醇和HDL-胆固醇的变化相关，分别为-9%、-19%和+0.2%，而从未使用HRT者为-9%、-14%和-0.8%。同样，对血小板计数无相互作用。相比之下，三苯氧胺诱导的总胆固醇和LDL-胆固醇水平的降低在开始HRT同时使用三苯氧胺的女性中减弱了三分之二（相互作用项P = 0.051）。我们的结论是，他莫昔芬对心血管危险因素的有益影响是不变的，在目前的HRT用户，而他们可能会减弱的妇女谁开始透皮HRT，而他莫昔芬。而他莫昔芬在已经接受透皮HRT的女性中的试验是必要的，在他莫昔芬期间的HRT处方可能会减弱其活性。
The combination of tamoxifen and transdermal hormone replacement therapy (HRT) may potentially reduce risks and side-effects of either agent, but an adverse interaction could attenuate their beneficial effects. We assessed the effects of their combination on cardiovascular risk factors within a prevention trial of tamoxifen. Baseline and 12-month measurements of total, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, platelets and white blood cells were obtained in the following four groups: tamoxifen (n = 1117), placebo (n = 1112), tamoxifen and HRT (n = 68), placebo and HRT (n = 87). The analysis was further extended to women who were on HRT at randomization but discontinued it during the 12-month intervention period (n = 33 on tamoxifen and n = 35 on placebo) and to women who were not on HRT but started it during intervention (n = 36 in both arms of the study). Compared with small changes in the placebo group, tamoxifen was associated with changes in total, LDL- and HDL-cholesterol of approximately -9%, -19% and +0.2% in continuous HRT users compared with -9%, -14% and -0.8% in never HRT users. Similarly, there was no interaction on platelet count. In contrast, the decrease in total and LDL-cholesterol levels induced by tamoxifen was blunted by two-thirds in women who started HRT while on tamoxifen (P = 0.051 for the interaction term). We conclude that the beneficial effects of tamoxifen on cardiovascular risk factors are unchanged in current HRT users, whereas they may be attenuated in women who start transdermal HRT while on tamoxifen. Whereas a trial of tamoxifen in women already on transdermal HRT is warranted, prescription of HRT during tamoxifen may attenuate its activity.
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DOI：
10.1093/jnci/89.11.776
发表时间：
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期刊：
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通讯作者：
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影响因子：
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DOI：
10.1210/jcem-70-6-1568
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影响因子：
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通讯作者：
Katzenellenbogen, BS