Dr Nick Panay1, Dr Rossella E. Nappi2, Dr Santiago Palacios3, Dr Tomasz Paszkowski4, Mr Julie Heroux5, Dr Mitra Boolell6
1Chelsea and Westminster Hospital, London, UK, 2Research Center for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy, 3Palacios Institute of Women’s Health, Madrid, Spain, 43rd Chair and Department of Gynaecology, Medical University of Lublin, Poland, 5Heroux Consulting, The Hague, Netherlands, 6Theramex, London, UK
Objective
To compare the VTE risk between postmenopausal women treated with 17β estradiol/micronised progesterone (E2/P4) versus conjugated equine estrogens/medroxyprogesterone acetate (CEE/MPA).
Methods
Postmenopausal women aged ≥40 y initiated on E2/P4 or CEE/MPA who did not have a VTE diagnosis pre-index were selected from a large US claims database (04/2019-06/2021). VTE risk was assessed from the first E2/P4 or CEE/MPA dispensing (index date) until switch to the comparator treatment or end of follow-up. Confounding control was achieved via inverse probability of treatment weighting (IPTW).
Results
The study included 6,526 women initiated on E2/P4 and 29,535 on CEE/MPA (mean follow-up: 1.2 and 1.4y post-index, respectively). All covariates, including age, cardiovascular disease and hypercholesterolemia, were balanced post-IPTW. The VTE incidence per 10,000 women years was 32 and 55 for E2/P4 and CEE/MPA before IPTW, and 37 and 53 after IPTW, respectively (post-IPTW incidence rate ratio 0.70, 95% confidence interval [CI] 0.53-0.92, p < 0.05). Hazard ratio from the IPTW analyses of time to first VTE was 0.70, 95% CI 0.53-0.92, p < 0.05 for E2/P4 vs CEE/MPA.
Conclusions
Results from these exploratory analyses indicate that the VTE risk may be lower among women initiated on E2/P4 compared to CEE/MPA.
Biography:
Professor Nick Panay is a Consultant Gynaecologist with a special interest in menopause, reproductive medicine and surgery, contraception and gynaecological endocrinology. He is director of the West London Menopause & PMS Centre at Queen Charlotte’s & Chelsea and Chelsea & Westminster Hospitals, leading clinical and research teams in women’s health research that is published widely in peer-reviewed journals and presented at scientific meetings nationally and internationally. Much of his team’s research has focused on improving the understanding and management of Premature Menopause, PMS, Female Sexual Dysfunction, New HRT and Contraceptive regimens and Complementary Therapies.