Comparative venous thromboembolic safety of oral and transdermal postmenopausal hormone therapies among women Veterans.
Comparative venous thromboembolic safety of oral and transdermal postmenopausal hormone therapies among women Veterans.
复制标题
DOI：
10.1097/gme.0000000000001823
复制
发表时间：
2021-07-26
期刊：
影响因子：
--
通讯作者：
Smith NL
中科院分区：
文献类型：
--
作者：
Blondon M;Timmons AK;Baraff AJ;Floyd JS;Harrington LB;Korpak AM;Smith NL
Hormone therapy (HT) is used by menopausal women to treat vasomotor symptoms. Venous thromboembolism (VTE) is an important risk of HT use, and more knowledge on the comparative safety of different estrogenic compounds is useful for women who use HT for these symptoms. The objective was to compare the risk of VTE among users of oral conjugated equine estrogen (CEE), oral estradiol (E2) and transdermal E2, in a cohort of women Veterans. This retrospective cohort study included all women Veterans aged 40-89 years, using CEE or E2, without prior VTE, between 2003 and 2011. All incident VTE events were adjudicated. Time-to-event analyses using a time-varying HT exposure evaluated the relative VTE risk between estrogen subtypes, with adjustment for age, race, and BMI, with stratification for prevalent vs. incident use of HT. Among 51,571 users of HT (74.5% CEE, 12.6% oral and 12.9% transdermal E2 at cohort entry), with a mean age of 54.0 years, the incidence of VTE was 1.9/1000 person-years. Compared with CEE use, in the multivariable regression model, there was no difference in the risk of incident VTE associated with oral E2 use (HR 0.96, 95%CI 0.64-1.46) or with transdermal E2 use (HR 0.95, 95%CI 0.60-1.49). Results were unchanged when restricting to incident users of HT. Among women Veterans, the risk of VTE was similar in users of oral CEE, oral E2 and transdermal E2. These findings do not confirm the previously observed greater safety of transdermal and oral E2 over CEE.
