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Effects of either tibolone or continuous combined transdermal estradiol with medroxyprogesterone acetate on coagulatory factors and lipoprotein(a) in menopause.
Gynecol Obstet Invest. 2009; 68(1):33-9.GO

Abstract

BACKGROUND/AIM

The aim of this prospective controlled study was to compare the effects of two therapies for menopause on factor VII (FVII) and hemostatic variables.

METHODS

Postmenopausal women were assigned to receive one of the following treatments: transdermal estradiol (TTS E2; 50 microg) combined in a continuous sequential regimen with oral medroxyprogesterone acetate (MPA; 10 mg/day for 12 days) (group A; n = 20), tibolone (2.5 mg/day) (group B; n = 21) or placebo (group C; n = 19). Sixty women completed the 1-year treatment and underwent follow-up examinations after 3, 6 and 12 months.

RESULTS

TTS E2/MPA induced various changes in procoagulatory factors. At 12 months, fibrinogen, activated FVII (FVIIa) and coagulative FVII (FVIIc) had increased by 10.7, 12.9 and 3.7%, respectively. Among the fibrinolytic factors, plasminogen and alpha2-antiplasmin increased by 11.3 and 7.2%, respectively. Lipoprotein(a) [Lp(a)] and antithrombin III (ATIII) did not show any significant variation. Tibolone induced some changes toward a more homogeneous antithrombotic profile. Fibrinogen, FVIIa and FVIIc decreased significantly by 7.5, 8.1 and 21.3%, respectively. Plasminogen increased (by 11.8%) and Lp(a) decreased (by 28.4%). ATIII was unchanged with tibolone therapy.

CONCLUSION

Our results show that tibolone induces a significant reduction in FVIIc and Lp(a) and a greater enhancement of factors promoting fibrinolysis than the TTS E2/MPA regimen.

Authors+Show Affiliations

Department of Gynecology and Obstetrics, University Sapienza, Rome, Italy. giuseppina.perrone@uniroma1.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19349712

Citation

Perrone, G, et al. "Effects of Either Tibolone or Continuous Combined Transdermal Estradiol With Medroxyprogesterone Acetate On Coagulatory Factors and Lipoprotein(a) in Menopause." Gynecologic and Obstetric Investigation, vol. 68, no. 1, 2009, pp. 33-9.
Perrone G, Capri O, Galoppi P, et al. Effects of either tibolone or continuous combined transdermal estradiol with medroxyprogesterone acetate on coagulatory factors and lipoprotein(a) in menopause. Gynecol Obstet Invest. 2009;68(1):33-9.
Perrone, G., Capri, O., Galoppi, P., Brunelli, R., Bevilacqua, E., Ceci, F., Ciarla, M. V., & Strom, R. (2009). Effects of either tibolone or continuous combined transdermal estradiol with medroxyprogesterone acetate on coagulatory factors and lipoprotein(a) in menopause. Gynecologic and Obstetric Investigation, 68(1), 33-9. https://doi.org/10.1159/000211676
Perrone G, et al. Effects of Either Tibolone or Continuous Combined Transdermal Estradiol With Medroxyprogesterone Acetate On Coagulatory Factors and Lipoprotein(a) in Menopause. Gynecol Obstet Invest. 2009;68(1):33-9. PubMed PMID: 19349712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of either tibolone or continuous combined transdermal estradiol with medroxyprogesterone acetate on coagulatory factors and lipoprotein(a) in menopause. AU - Perrone,G, AU - Capri,O, AU - Galoppi,P, AU - Brunelli,R, AU - Bevilacqua,E, AU - Ceci,F, AU - Ciarla,M V, AU - Strom,R, Y1 - 2009/04/07/ PY - 2009/4/8/entrez PY - 2009/4/8/pubmed PY - 2009/10/16/medline SP - 33 EP - 9 JF - Gynecologic and obstetric investigation JO - Gynecol. Obstet. Invest. VL - 68 IS - 1 N2 - BACKGROUND/AIM: The aim of this prospective controlled study was to compare the effects of two therapies for menopause on factor VII (FVII) and hemostatic variables. METHODS: Postmenopausal women were assigned to receive one of the following treatments: transdermal estradiol (TTS E2; 50 microg) combined in a continuous sequential regimen with oral medroxyprogesterone acetate (MPA; 10 mg/day for 12 days) (group A; n = 20), tibolone (2.5 mg/day) (group B; n = 21) or placebo (group C; n = 19). Sixty women completed the 1-year treatment and underwent follow-up examinations after 3, 6 and 12 months. RESULTS: TTS E2/MPA induced various changes in procoagulatory factors. At 12 months, fibrinogen, activated FVII (FVIIa) and coagulative FVII (FVIIc) had increased by 10.7, 12.9 and 3.7%, respectively. Among the fibrinolytic factors, plasminogen and alpha2-antiplasmin increased by 11.3 and 7.2%, respectively. Lipoprotein(a) [Lp(a)] and antithrombin III (ATIII) did not show any significant variation. Tibolone induced some changes toward a more homogeneous antithrombotic profile. Fibrinogen, FVIIa and FVIIc decreased significantly by 7.5, 8.1 and 21.3%, respectively. Plasminogen increased (by 11.8%) and Lp(a) decreased (by 28.4%). ATIII was unchanged with tibolone therapy. CONCLUSION: Our results show that tibolone induces a significant reduction in FVIIc and Lp(a) and a greater enhancement of factors promoting fibrinolysis than the TTS E2/MPA regimen. SN - 1423-002X UR - https://www.unboundmedicine.com/medline/citation/19349712/Effects_of_either_tibolone_or_continuous_combined_transdermal_estradiol_with_medroxyprogesterone_acetate_on_coagulatory_factors_and_lipoprotein_a__in_menopause_ L2 - https://www.karger.com?DOI=10.1159/000211676 DB - PRIME DP - Unbound Medicine ER -