绝经过渡期和绝经后激素治疗新进展.ppt

The distribution of the recurrences is shown in this slide. It is clear that the majority of the recurences were distant in nature. The HR although not statistically significant (due to lower numbers) shows a similar pattern between the localisations There was a statistically significant improvement on vasomottor symptoms with tibolone compared to placebo from 12 weeks until 3 years. Bone Mineral Density was measured in a subgroup and showed an statistically significant improvement in Lumbar Spine and Total Hip (not shown) BMD. * Both treatments significantly improved the karyopyknotic index and vaginal maturation value when compared with baseline (P 0.001). There was no differences between treatment groups (Figure 4). * NOTES ? Livial? is a Tissue-Selective therapy which, depending on the tissue, exerts an estrogenic, progestogenic or androgenic effect. After oral ingestion it is converted into three active metabolites: an ?4 isomer, a 3a-hydroxy metabolite and a 3b-hydroxy metabolite. The 3a and the 3b-hydroxy metabolites bind solely to the estrogen receptor, whereas the ?4 isomer has affinity for both progestogen and androgen receptors, but not to the estrogen receptors. ? Livial? has an estrogenic effect on bone and prevents postmenopausal bone loss. Livial? has already been used in the treatment of climacteric symptoms and the prevention and treatment of osteoporosis for more than 10 years. ? Livial? effectively controls climacteric symptoms including neuroendocrinological symptoms, such as hot flushes and night sweats, and urogenital symptoms including vaginal dryness and atrophy1. Livial’s? effect on bone will be discussed in the following slides. Reference 1. Rymer JM. The effects of tibolone. Gynecol Endocrinol 1998;12:213–20. * * * * * * Methods The subjects were 420 women, an average of 66.4 years old, who had been postmenopausal between 8 and 19 years when enrolled in the study. Of the 420 women enrolled, 346 agreed to take tibolone for 5 years. The