Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
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DOI：
10.1007/s00198-020-05497-8
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Harvey NC
中科院分区：
文献类型：
--
作者：
Rozenberg S;Al-Daghri N;Aubertin-Leheudre M;Brandi ML;Cano A;Collins P;Cooper C;Genazzani AR;Hillard T;Kanis JA;Kaufman JM;Lambrinoudaki I;Laslop A;McCloskey E;Palacios S;Prieto-Alhambra D;Reginster JY;Rizzoli R;Rosano G;Trémollieres F;Harvey NC
我们为使用绝经期激素治疗（MHT）来维持骨骼健康和预防最近绝经妇女未来骨折提供了证据基础和指导。尽管存在争议的相关副作用，这限制了它的使用在最近几十年中，绝经后不久的MHT在绝经后骨质疏松症的管理中的潜在作用越来越多地被认可。我们提出了一个叙事审查的好处与风险使用MHT在管理绝经后骨质疏松症。目前的文献表明，MHT在低BMD患者中具有稳健的抗骨折疗效，无论是否与孕激素合并使用，但停止治疗后持续骨骼益处的证据有限。副作用包括心血管事件、血栓栓塞性疾病、中风和乳腺癌，但获益-风险特征因使用对抗性与非对抗性雌激素、雌激素/孕激素类型、给药剂量和途径以及心血管事件、MHT使用时间而异。总体而言，获益-风险特征支持MHT治疗最近（< 10年）绝经、有绝经症状和年龄小于60岁、不良事件基线风险低的女性。MHT应被视为维持女性骨骼健康的一种选择，特别是在绝经期或绝经后不久开始时，在个性化获益-风险评估的背景下，作为治疗绝经期症状的额外获益。
We provide an evidence base and guidance for the use of menopausal hormone therapy (MHT) for the maintenance of skeletal health and prevention of future fractures in recently menopausal women. Despite controversy over associated side effects, which has limited its use in recent decades, the potential role for MHT soon after menopause in the management of postmenopausal osteoporosis is increasingly recognized. We present a narrative review of the benefits versus risks of using MHT in the management of postmenopausal osteoporosis. Current literature suggests robust anti-fracture efficacy of MHT in patients unselected for low BMD, regardless of concomitant use with progestogens, but with limited evidence of persisting skeletal benefits following cessation of therapy. Side effects include cardiovascular events, thromboembolic disease, stroke and breast cancer, but the benefit-risk profile differs according to the use of opposed versus unopposed oestrogens, type of oestrogen/progestogen, dose and route of delivery and, for cardiovascular events, timing of MHT use. Overall, the benefit-risk profile supports MHT treatment in women who have recently (< 10 years) become menopausal, who have menopausal symptoms and who are less than 60 years old, with a low baseline risk for adverse events. MHT should be considered as an option for the maintenance of skeletal health in women, specifically as an additional benefit in the context of treatment of menopausal symptoms, when commenced at the menopause, or shortly thereafter, in the context of a personalized benefit-risk evaluation.
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影响因子：
39.2
作者：
ALBRIGHT, F
通讯作者：
ALBRIGHT, F
影响因子：
4.9
作者：
Armeni, Eleni;Lambrinoudaki, Irene;Rees, Margaret
通讯作者：
Rees, Margaret
影响因子：
39.2
作者：
Harman, S. Mitchell;Black, Dennis M.;Hodis, Howard N.
通讯作者：
Hodis, Howard N.
DOI：
10.1097/gme.0000000000000956
发表时间：
2018-01
期刊：
Menopause (New York, N.Y.)
影响因子：
--
作者：
Crandall CJ;Hovey KM;Andrews CA;Chlebowski RT;Stefanick ML;Lane DS;Shifren J;Chen C;Kaunitz AM;Cauley JA;Manson JE
通讯作者：
Manson JE
影响因子：
8.7
作者：
Angerer, P;Störk, S;von Schacky, C
通讯作者：
von Schacky, C