Mirkin Sebastian, Komm Barry, Pickar James H
Pfizer Inc., 500 Arcola Rd, Room B-4207, Collegeville, PA 19426, USA.
Womens Health (Lond). 2014 Mar;10(2):135-46. doi: 10.2217/whe.13.75.
Conjugated estrogen/bazedoxifene (CE/BZA) therapy represents a new, progestin-free treatment in the management of postmenopausal health. CE/BZA pairs CE with the selective estrogen receptor modulator, BZA. The rationale for the development of CE/BZA was that BZA, acting primarily as a selective estrogen receptor degrader in uterine and breast tissue, would sufficiently inhibit the proliferative effects of CE on the endometrium. The absence of a progestin would reduce the incidence of uterine bleeding, breast pain and increased breast density associated with progestin-containing hormone therapy. CE/BZA has been evaluated in five multicenter, randomized, double-blind, placebo-controlled, and active-controlled Phase III trials known as the SMART trials. CE/BZA has been shown to maintain the established benefits of estrogen therapy for treatment of vasomotor symptoms and prevention of a loss in bone mineral density (bone mass), while minimizing certain estrogenic effects, particularly in the uterine endometrium and breast.
共轭雌激素/巴多昔芬(CE/BZA)疗法是绝经后健康管理中一种新的无孕激素治疗方法。CE/BZA将共轭雌激素与选择性雌激素受体调节剂巴多昔芬相结合。研发CE/BZA的基本原理是,巴多昔芬主要作为子宫和乳腺组织中的选择性雌激素受体降解剂,将充分抑制共轭雌激素对子宫内膜的增殖作用。无孕激素可降低与含孕激素激素疗法相关的子宫出血、乳房疼痛和乳腺密度增加的发生率。CE/BZA已在五项多中心、随机、双盲、安慰剂对照和活性对照的III期试验(即SMART试验)中进行了评估。结果表明,CE/BZA在维持雌激素疗法对血管舒缩症状的既定疗效以及预防骨矿物质密度(骨量)损失的同时,能将某些雌激素作用降至最低,尤其是对子宫内膜和乳腺的作用。