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经皮与口服激素替代疗法的比较:一项关于新型基质贴片的多中心研究

[Comparison of transdermal with oral hormone substitution: a multicenter study with a new matrix patch].

作者信息

Sajtos B, Herold J, Winkler U H, Schindler A E

机构信息

Rhône-Poulence Rorer GmbH, Köln.

出版信息

Zentralbl Gynakol. 1995;117(10):524-30.

PMID:7491835
Abstract

166 postmenopausal patients, aged 45-65 years at baseline, with moderate to severe climacteric symptoms were randomly allocated to an open-label, multi-center study which compared the efficacy, safety and acceptance of a transdermal 17 beta-estradiol matrix patch with an oral form of estrogen replacement therapy. In a cyclic sequential regimen, the transdermal system delivered 0.05 mg of estradiol/day. Oral dosages of conjugated equine estrogens were 0.625 mg/day. An oral progestin was also given for 11 days in each cycle for each group. A statistically significant reduction compared to baseline in the primary efficacy parameter, the mean number of hot flashes, occurred with a decrease in each group from 6 per day at baseline to 1 per day at 12 weeks; there was no statistically significant difference between the two groups. The incidence and severity of other postmenopausal symptoms, particularly sweating, difficulty in concentration and palpitations were reduced to a greater extent in the patch group without revealing a significant inter-group difference in the total symptom score. There were also no statistically significant differences in the mean serum estradiol and FSH concentrations between the two treatment groups after 12 weeks of therapy. A similar number of adverse events was observed in both groups. The most frequent adverse events were breast pain and under oral estrogen therapy, gastrointestinal complaints and weight increase. Skin irritation or dermatitis occurred infrequently in the patch group. In summary, the matrix patch represents at least as effective a therapy for postmenopausal symptoms as a standard oral estrogen.

摘要

166名绝经后女性患者,基线年龄为45 - 65岁,有中度至重度更年期症状,被随机分配至一项开放标签的多中心研究,该研究比较了经皮17β - 雌二醇基质贴片与口服雌激素替代疗法的疗效、安全性和可接受性。在周期性序贯疗法中,经皮系统每日释放0.05mg雌二醇。口服结合马雌激素的剂量为每日0.625mg。每组在每个周期还给予口服孕激素11天。主要疗效参数潮热的平均次数与基线相比有统计学意义的降低,每组从基线时的每日6次降至12周时的每日1次;两组之间无统计学显著差异。在贴片组中,其他绝经后症状的发生率和严重程度,尤其是出汗、注意力不集中和心悸,有更大程度的降低,且在总症状评分上未显示出显著的组间差异。治疗12周后,两个治疗组之间的平均血清雌二醇和促卵泡激素浓度也无统计学显著差异。两组观察到的不良事件数量相似。最常见的不良事件是乳房疼痛,口服雌激素治疗时还有胃肠道不适和体重增加。贴片组很少发生皮肤刺激或皮炎。总之,基质贴片治疗绝经后症状至少与标准口服雌激素一样有效。

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