自然绝经女性的治疗：一项来自美国、英国和德国的队列研究。

Saadedine Mariam, Banks Victoria, Dinkel-Keuthage Carina, Caetano Cecilia, Argyriou George, Moeller Carsten, Schoof Nils, Vizcaya David, Francuski Maja, Golozar Asieh, Römer Thomas, Kubba Ali

Department of Obstetrics and Gynecology, George Washington University, Washington, DC, USA.

Medical Affairs and Pharmacovigilance, Bayer Plc, Reading, UK.

Climacteric. 2025 Jul 30:1-8. doi: 10.1080/13697137.2025.2530466.

OBJECTIVES

This study aimed to describe treatment patterns among naturally menopausal women from the USA, the UK and Germany.

METHODS

Using health claims (the USA) and electronic health records (the UK and Germany), women aged 40-65 years with a first record of natural menopause (index date) from 2009 to 2022 were identified. Women with a history of bilateral oophorectomy, total hysterectomy, endocrine therapy for breast cancer or hormone/non-hormone therapy for menopausal symptoms were excluded. Treatments evaluated following the index date were hormone therapy, benzodiazepines, antidepressants, anticonvulsants and the antihypertensive clonidine.

RESULTS

In total, 1,260,742 (the USA), 214,374 (the UK) and 124,542 (Germany) women were included, and treatments were recorded in 38.8%, 33.4% and 28.8%, respectively. Among these, the majority received one treatment class, mostly hormone therapy (44.2% for the USA, 41.1% for the UK, 92.6% for Germany), benzodiazepines (25.3% for the USA, 6.8% for the UK, 2.2% for Germany) and antidepressants (18.6% for the USA, 33.5% for the UK, 4.1% for Germany). Discontinuation rates at 6 months from starting initial treatment were 75.0-88.0% for hormone therapy, 65.0-85.0% for antidepressants and ≥98% for benzodiazepines. Treatment switches occurred in 25.4% (the USA), 21.8% (the UK) and 1.7% (Germany).

CONCLUSIONS

Continuation rates with current treatments for women experiencing natural menopausal symptoms are low, indicating an unmet need for effective and acceptable therapies.

目的

本研究旨在描述美国、英国和德国自然绝经女性的治疗模式。

方法

利用健康保险理赔数据（美国）以及电子健康记录（英国和德国），确定了2009年至2022年期间年龄在40 - 65岁且有首次自然绝经记录（索引日期）的女性。排除有双侧卵巢切除术、全子宫切除术史、乳腺癌内分泌治疗史或绝经症状激素/非激素治疗史的女性。索引日期之后评估的治疗包括激素治疗、苯二氮䓬类药物、抗抑郁药、抗惊厥药和抗高血压药可乐定。

结果

总共纳入了1260742名女性（美国）、214374名女性（英国）和124542名女性（德国），治疗记录分别为38.8%、33.4%和28.8%。其中，大多数人接受一种治疗类别，主要是激素治疗（美国为44.2%，英国为41.1%，德国为92.6%）、苯二氮䓬类药物（美国为25.3%，英国为6.8%，德国为2.2%）和抗抑郁药（美国为18.6%，英国为33.5%，德国为4.1%）。初始治疗开始后6个月的停药率，激素治疗为75.0 - 88.0%，抗抑郁药为65.0 - 85.0%，苯二氮䓬类药物≥98%。治疗转换发生在25.4%（美国）、21.8%（英国）和1.7%（德国）。