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在妇女健康倡议(WHI)研究时代之后,绝经后妇女中绝经激素治疗的停药率。

Discontinuation rates of menopausal hormone therapy among postmenopausal women in the post-WHI study era.

作者信息

Kyvernitakis I, Kostev K, Hars O, Albert U-S, Hadji P

机构信息

a Department of Gynecological Endocrinology , Reproductive Medicine and Osteoporosis, Philipps-University of Marburg , Germany.

b * IMS Health , Frankfurt , Germany.

出版信息

Climacteric. 2015 Oct;18(5):737-42. doi: 10.3109/13697137.2015.1037267. Epub 2015 Jul 15.

DOI:10.3109/13697137.2015.1037267
PMID:25845443
Abstract

OBJECTIVES

Many women are reluctant to take menopausal hormone therapy (MHT) and discontinue the treatment within 12 months. The aim of this study was to investigate the persistence rates of combined MHT in the last decade, reflecting changes in the post-Women's Health Initiative era.

METHODS

We analyzed 17 020 patients receiving combined MHT from 2004 to 2013 using the Disease Analyzer database.

RESULTS

After 12 months of follow-up, 44.6% and 33.5% of patients receiving 1 mg and 2 mg, respectively, of oral combined MHT were still on treatment (p < 0.0001). The persistence rate of patients receiving < 50 μg of transdermal MHT was 39.1% after 1 year of treatment and presented no differences compared to patients receiving ≥ 50 μg of transdermal MHT with a persistence rate of 38.2%. MHT start in the years 2007-2009 was associated with higher discontinuation rates (hazard ratio 1.04, p = 0.0709) than MHT start in the years 2010-2013 (hazard ratio 0.90, p = 0.0001).

CONCLUSIONS

Our results indicate that patients beginning their treatments in the years 2010-2013 were more treatment-persistent than patients beginning with MHT in the early years after publication of the Women's Health Initiative study (2004-2009). Administration of low-dose oral MHT and transdermal MHT is associated with increased persistency compared to higher doses of oral MHT.

摘要

目的

许多女性不愿接受绝经激素治疗(MHT),并在12个月内停止治疗。本研究的目的是调查过去十年中联合MHT的持续率,以反映妇女健康倡议(Women's Health Initiative)时代后的变化。

方法

我们使用疾病分析仪数据库分析了2004年至2013年期间接受联合MHT的17020例患者。

结果

随访12个月后,接受1mg和2mg口服联合MHT的患者分别有44.6%和33.5%仍在接受治疗(p<0.0001)。接受<50μg经皮MHT的患者在治疗1年后的持续率为39.1%,与接受≥50μg经皮MHT且持续率为38.2%的患者相比无差异。2007 - 2009年开始MHT的患者停药率(风险比1.04,p = 0.0709)高于2010 - 2013年开始MHT的患者(风险比0.90,p = 0.0001)。

结论

我们的结果表明,与妇女健康倡议研究发表后的早期(2004 - 2009年)开始接受MHT的患者相比,2010 - 2013年开始治疗的患者治疗依从性更高。与高剂量口服MHT相比,低剂量口服MHT和经皮MHT的给药与更高的持续性相关。

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