2010, Number 03
Estrogen therapy in menopause. Clinical study in evolution (KEEPS) to explain the risk-benefit dispute to administration
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ABSTRACTThe Kronos Early Estrogen Prevention Study (KEEPS) is a randomized clinical and controlled study, with the objective of clarifying the controversy that arisen previous studies about the risk-benefit factor with use of estrogens in postmenopausal women. Healthy women aged 42-58 years who are within 36 months of their last menstrual period have been recruited to receive either oral estrogens or patches of estradiol; in addition both groups are given oral micronized progesterone for 11 days of each month. Outcomes will be carotid intimae medial thickness and the accrual of coronary calcium; collaterally subrogate outcomes will be lipoproteins concentrations, coagulation markers, bone densitometry, mammography, skin characteristics and cognitive evaluation.
The hypothesis consists in the presence of a window of therapeutic opportunity for the use of estrogens in low dose in healthy women with recent menopause.
Manson JE, Bassuk SS, Harman SM, et al. Postmenopausal hormone therapy: new questions and the case for new clinical trials. Menopause 2006;13:139-147.
Colditz GA, Willet WC, Hunter DJ, et al. Family history, age and risk of breast cancer. Prospective data from the Nurses’ Health Study. JAMA 1993;270:338-343.
Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogens plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321-333.
HERS research group. Cardiovascular disease outcomes during 6-8 years of hormone therapy. Heart and estrogens/progestin replacement study follow-up (HERS II). JAMA 2002;288:49-57.
Bath PMW, Gray LJ. Association between hormone replacement therapy and subsequent stroke: a meta-analysis. BMJ 2005;330:342-344.
Ettinger B, Barret-Connor E, Hop LA, et al. When is it appropriate to prescribe postmenopausal hormone therapy? Menopause 2006;13:404-410.
Zárate A, Saucedo R, Basurto L, Martínez C. La enfermedad cardiovascular como amenaza actual para la mujer adulta mayor. La relación con los estrógenos. Ginecol Obstet Mex 2007;75:286-292.
Zárate A, Hernández VA, Basurto L. Estado actual del tratamiento hormonal en la menopausia. Rev Fac Med UNAM 2005;48:14-19.