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Conventional-dose hormone therapy (HT) and tibolone, but not low-dose HT and raloxifene, increase markers of activated coagulation.
Maturitas. 2006 Oct 20; 55(3):278-87.M

Abstract

OBJECTIVES

Hormone therapy (HT) is associated with a modest, but significantly increased risk for arterial and venous thromboembolism. We have compared the effects of estrogen, tibolone, and raloxifene on relevant markers of coagulation activation and investigated whether there is a dose-response relationship of oral HT.

METHODS

Randomized, open-label, comparative study of 202 healthy women who were assigned to receive treatment for 12 weeks with either low-dose hormone therapy containing 1 mg 17beta-estradiol + 0.5 mg norethisterone acetate (NETA) (n=50), conventional-dose HT containing 2 mg 17beta-estradiol and 1 mg NETA (n=50), 2.5 mg tibolone (n=51), or 60 mg raloxifene (n=51).

RESULTS

The groups were comparable with regard to demographic characteristics and laboratory variables at baseline. D-dimer increased markedly in the conventional-dose HT group, but remained unchanged in the low-dose HT group. Tibolone was associated with a medium increase, whereas raloxifene was associated with a decrease in D-dimer levels. Changes in prothrombin fragment 1 + 2 showed a similar pattern for all four groups, whereas no significant differences in changes of thrombin-antithrombin complex were observed.

CONCLUSIONS

Our data suggest that low-dose HT is associated with less activation of coagulation than conventional-dose HT. This finding may be of clinical importance since randomized clinical trials showing increased risk of thrombosis have utilized conventional-dose HT.

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Authors+Show Affiliations

Eilertsen AL
Department of Hematology, Ullevaal University Hospital Trust, Hematological Research Laboratory, NO-0407 Oslo, Norway. a.l.eilertsen@medisin.uio.no
Qvigstad E
No affiliation info available
Andersen TO
No affiliation info available
Sandvik L
No affiliation info available
Sandset PM
No affiliation info available

MeSH

Antineoplastic Agents, HormonalBlood CoagulationBlood Coagulation TestsBone Density Conservation AgentsDrug Therapy, CombinationEstradiolFemaleHormone Replacement TherapyHumansMiddle AgedNorethindroneNorethindrone AcetateNorpregnenesRaloxifene HydrochlorideThromboembolism

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16713143

Citation

Eilertsen, A L., et al. "Conventional-dose Hormone Therapy (HT) and Tibolone, but Not Low-dose HT and Raloxifene, Increase Markers of Activated Coagulation." Maturitas, vol. 55, no. 3, 2006, pp. 278-87.
Eilertsen AL, Qvigstad E, Andersen TO, et al. Conventional-dose hormone therapy (HT) and tibolone, but not low-dose HT and raloxifene, increase markers of activated coagulation. Maturitas. 2006;55(3):278-87.
Eilertsen, A. L., Qvigstad, E., Andersen, T. O., Sandvik, L., & Sandset, P. M. (2006). Conventional-dose hormone therapy (HT) and tibolone, but not low-dose HT and raloxifene, increase markers of activated coagulation. Maturitas, 55(3), 278-87.
Eilertsen AL, et al. Conventional-dose Hormone Therapy (HT) and Tibolone, but Not Low-dose HT and Raloxifene, Increase Markers of Activated Coagulation. Maturitas. 2006 Oct 20;55(3):278-87. PubMed PMID: 16713143.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conventional-dose hormone therapy (HT) and tibolone, but not low-dose HT and raloxifene, increase markers of activated coagulation. AU - Eilertsen,A L, AU - Qvigstad,E, AU - Andersen,T O, AU - Sandvik,L, AU - Sandset,P M, Y1 - 2006/05/18/ PY - 2006/01/30/received PY - 2006/04/04/revised PY - 2006/04/11/accepted PY - 2006/5/23/pubmed PY - 2007/1/31/medline PY - 2006/5/23/entrez SP - 278 EP - 87 JF - Maturitas JO - Maturitas VL - 55 IS - 3 N2 - OBJECTIVES: Hormone therapy (HT) is associated with a modest, but significantly increased risk for arterial and venous thromboembolism. We have compared the effects of estrogen, tibolone, and raloxifene on relevant markers of coagulation activation and investigated whether there is a dose-response relationship of oral HT. METHODS: Randomized, open-label, comparative study of 202 healthy women who were assigned to receive treatment for 12 weeks with either low-dose hormone therapy containing 1 mg 17beta-estradiol + 0.5 mg norethisterone acetate (NETA) (n=50), conventional-dose HT containing 2 mg 17beta-estradiol and 1 mg NETA (n=50), 2.5 mg tibolone (n=51), or 60 mg raloxifene (n=51). RESULTS: The groups were comparable with regard to demographic characteristics and laboratory variables at baseline. D-dimer increased markedly in the conventional-dose HT group, but remained unchanged in the low-dose HT group. Tibolone was associated with a medium increase, whereas raloxifene was associated with a decrease in D-dimer levels. Changes in prothrombin fragment 1 + 2 showed a similar pattern for all four groups, whereas no significant differences in changes of thrombin-antithrombin complex were observed. CONCLUSIONS: Our data suggest that low-dose HT is associated with less activation of coagulation than conventional-dose HT. This finding may be of clinical importance since randomized clinical trials showing increased risk of thrombosis have utilized conventional-dose HT. SN - 0378-5122 UR - https://www.unboundmedicine.com/medline/citation/16713143/Conventional_dose_hormone_therapy__HT__and_tibolone_but_not_low_dose_HT_and_raloxifene_increase_markers_of_activated_coagulation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-5122(06)00132-0 DB - PRIME DP - Unbound Medicine ER -