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Differential impact of conventional-dose and low-dose postmenopausal hormone therapy, tibolone and raloxifene on C-reactive protein and other inflammatory markers.
J Thromb Haemost. 2008 Jun; 6(6):928-34.JT

Abstract

BACKGROUND

Postmenopausal hormone therapy (HT) is associated with an increased risk for arterial and venous thrombosis.

OBJECTIVES

To compare the impact of HT, tibolone, and raloxifene on C-reactive protein (CRP) and other inflammatory markers, and to investigate possible underlying mechanisms for changes in CRP and D-dimer.

METHODS

Two hundred and two healthy women were randomly assigned to treatment for 12 weeks with either low-dose HT containing 1 mg of 17beta-estradiol and 0.5 mg of norethisterone acetate (NETA) (n = 50), conventional-dose HT containing 2 mg of 17beta-estradiol and 1 mg of NETA (n = 50), 2.5 mg of tibolone (n = 51), or 60 mg of raloxifene (n = 51).

RESULTS

CRP increased in the conventional-dose HT and low-dose HT groups. These changes were significantly more pronounced in the conventional-dose HT group (RMANOVA, P = 0.02). Also, tibolone was associated with an increase in CRP, in contrast to raloxifene, which reduced CRP. Reductions in levels of Lp(a), intercellular adhesion molecule-1 (ICAM-1), P-selectin, E-selectin, monocyte chemotactic protein 1 (MCP-1) and interleukin-6 (IL-6) were observed in all treatment groups. The changes were most pronounced for the conventional-dose HT group, and least pronounced for the raloxifene group, whereas the changes in those allocated to tibolone and low-dose HT were intermediary. Increased levels of tumor necrosis factor (TNF)-alpha and von Willebrand factor (VWF) were seen in the raloxifene group. We observed positive associations between changes in IL-6, VWF, MCP-1, and CRP.

CONCLUSIONS

The regimens had markedly different impacts on markers of inflammation. The average increase in CRP was not accompanied by increases in the average levels of IL-6, TNF-alpha or other markers, but women with large reductions in IL-6 had reduced increases in CRP.

Authors+Show Affiliations

Department of Haematology, Ullevål University Hospital Trust, Oslo, and Faculty Division Ullevål University Hospital, Oslo, Norway. a.l.eilertsen@medisin.uio.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

18394014

Citation

Eilertsen, A L., et al. "Differential Impact of Conventional-dose and Low-dose Postmenopausal Hormone Therapy, Tibolone and Raloxifene On C-reactive Protein and Other Inflammatory Markers." Journal of Thrombosis and Haemostasis : JTH, vol. 6, no. 6, 2008, pp. 928-34.
Eilertsen AL, Sandvik L, Steinsvik B, et al. Differential impact of conventional-dose and low-dose postmenopausal hormone therapy, tibolone and raloxifene on C-reactive protein and other inflammatory markers. J Thromb Haemost. 2008;6(6):928-34.
Eilertsen, A. L., Sandvik, L., Steinsvik, B., & Sandset, P. M. (2008). Differential impact of conventional-dose and low-dose postmenopausal hormone therapy, tibolone and raloxifene on C-reactive protein and other inflammatory markers. Journal of Thrombosis and Haemostasis : JTH, 6(6), 928-34. https://doi.org/10.1111/j.1538-7836.2008.02970.x
Eilertsen AL, et al. Differential Impact of Conventional-dose and Low-dose Postmenopausal Hormone Therapy, Tibolone and Raloxifene On C-reactive Protein and Other Inflammatory Markers. J Thromb Haemost. 2008;6(6):928-34. PubMed PMID: 18394014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential impact of conventional-dose and low-dose postmenopausal hormone therapy, tibolone and raloxifene on C-reactive protein and other inflammatory markers. AU - Eilertsen,A L, AU - Sandvik,L, AU - Steinsvik,B, AU - Sandset,P M, Y1 - 2008/04/03/ PY - 2008/4/9/pubmed PY - 2008/9/25/medline PY - 2008/4/9/entrez SP - 928 EP - 34 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 6 IS - 6 N2 - BACKGROUND: Postmenopausal hormone therapy (HT) is associated with an increased risk for arterial and venous thrombosis. OBJECTIVES: To compare the impact of HT, tibolone, and raloxifene on C-reactive protein (CRP) and other inflammatory markers, and to investigate possible underlying mechanisms for changes in CRP and D-dimer. METHODS: Two hundred and two healthy women were randomly assigned to treatment for 12 weeks with either low-dose HT containing 1 mg of 17beta-estradiol and 0.5 mg of norethisterone acetate (NETA) (n = 50), conventional-dose HT containing 2 mg of 17beta-estradiol and 1 mg of NETA (n = 50), 2.5 mg of tibolone (n = 51), or 60 mg of raloxifene (n = 51). RESULTS: CRP increased in the conventional-dose HT and low-dose HT groups. These changes were significantly more pronounced in the conventional-dose HT group (RMANOVA, P = 0.02). Also, tibolone was associated with an increase in CRP, in contrast to raloxifene, which reduced CRP. Reductions in levels of Lp(a), intercellular adhesion molecule-1 (ICAM-1), P-selectin, E-selectin, monocyte chemotactic protein 1 (MCP-1) and interleukin-6 (IL-6) were observed in all treatment groups. The changes were most pronounced for the conventional-dose HT group, and least pronounced for the raloxifene group, whereas the changes in those allocated to tibolone and low-dose HT were intermediary. Increased levels of tumor necrosis factor (TNF)-alpha and von Willebrand factor (VWF) were seen in the raloxifene group. We observed positive associations between changes in IL-6, VWF, MCP-1, and CRP. CONCLUSIONS: The regimens had markedly different impacts on markers of inflammation. The average increase in CRP was not accompanied by increases in the average levels of IL-6, TNF-alpha or other markers, but women with large reductions in IL-6 had reduced increases in CRP. SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/18394014/Differential_impact_of_conventional_dose_and_low_dose_postmenopausal_hormone_therapy_tibolone_and_raloxifene_on_C_reactive_protein_and_other_inflammatory_markers_ L2 - https://doi.org/10.1111/j.1538-7836.2008.02970.x DB - PRIME DP - Unbound Medicine ER -