Less effect of intranasal than oral hormone therapy on factors associated with venous thrombosis risk in healthy postmenopausal women

Arteriosclerosis, Thrombosis, and Vascular Biology
Majoie HemelaarMarius J van der Mooren

Abstract

To compare the effects of intranasal and oral administration of 17beta-estradiol (E2) and norethisterone(acetate) [NET(A)] in healthy postmenopausal women on activated protein C (APC) resistance and other hemostatic parameters associated with venous thrombosis. In this 2-center, randomized, double-blind, 1-year trial, 90 postmenopausal women (56.6+/-4.7 years of age) received daily either an intranasal spray with 175 microg/275 microg E2/NET (n=47) or 1 mg/0.5 mg oral E2/NETA (n = 43). Normalized APC sensitivity ratios (nAPCsr) were determined with a thrombin generation-based APC resistance test. After 1 year, the increase in nAPCsr was smaller in the intranasal than in the oral group: 11% (95% CI, 1% to 22%) versus 53% (95% CI, 37% to 72%). Overall, the decrease in antithrombin and increase in prothrombin fragment 1+2 (F1+2) were smaller and the decrease in free protein S larger in the intranasal compared with the oral group after 1 year. In both groups, the decreases in protein C and prothrombin, and the increase in d-dimer were similar. Compared with oral E2/NETA therapy, intranasal administration of E2/NET had less effect on APC resistance and on a number of other parameters associated with venous thrombosis. This observati...Continue Reading

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Citations

Aug 19, 2007·Menopause : the Journal of the North American Menopause Society·Majoie HemelaarMarius J van der Mooren
Jul 9, 2010·Menopause : the Journal of the North American Menopause Society·Marianne CanonicoPierre-Yves Scarabin
Apr 14, 2011·Menopause : the Journal of the North American Menopause Society·Pierre-Yves ScarabinMartine Alhenc-Gelas
Sep 29, 2011·Climacteric : the Journal of the International Menopause Society·J A A M van DijckM J van der Mooren
Feb 3, 2016·Menopause : the Journal of the North American Menopause Society·Magdalena M PirógAnetta Undas

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