This meta- analysis shows that oral tibolone treatment significantly lowers circulating Lp(a ) levels in postmenopausal women .
INTRODUCTION Circulating lipoprotein ( a ) ( Lp(a ) ) is a recognized risk factor for cardiovascular disease ( CVD ) .
Tibolone , a synthetic steroid , may lower Lp(a ) levels ; however , evidence of the effects of tibolone on Lp(a ) still remain to be defined .
Therefore , we investigated the effects of tibolone treatment on circulating Lp(a ) levels in postmenopausal women .
The effects of tibolone in older postmenopausal women.
BACKGROUND Tibolone has estrogenic , progestogenic , and and rogenic effects . Although tibolone prevents bone loss , its effects on fractures , breast cancer , and cardiovascular disease are uncertain . METHODS In this r and omized study , we assigned 4538 women , who were between the ages of 60 and 85 years and had a bone mineral density T score of -2.5 or less at the hip or spine or a T score of -2.0 or less and radiologic evidence of a vertebral fracture , to receive once-daily tibolone ( at a dose of 1.25 mg ) or placebo . Annual spine radiographs were used to assess for vertebral fracture . Rates of cardiovascular events and breast cancer were adjudicated by expert panels . RESULTS During a median of 34 months of treatment , the tibolone group , as compared with the placebo group , had a decreased risk of vertebral fracture , with 70 cases versus 126 cases per 1000 person-years ( relative hazard , 0.55 ; 95 % confidence interval [ CI ] , 0.41 to 0.74 ; P<0.001 ) , and a decreased risk of nonvertebral fracture , with 122 cases versus 166 cases per 1000 person-years ( relative hazard , 0.74 ; 95 % CI , 0.58 to 0.93 ; P=0.01 ) . The tibolone group also had a decreased risk of invasive breast cancer ( relative hazard , 0.32 ; 95 % CI , 0.13 to 0.80 ; P=0.02 ) and colon cancer ( relative hazard , 0.31 ; 95 % CI , 0.10 to 0.96 ; P=0.04 ) . However , the tibolone group had an increased risk of stroke ( relative hazard , 2.19 ; 95 % CI , 1.14 to 4.23 ; P=0.02 ) , for which the study was stopped in February 2006 at the recommendation of the data and safety monitoring board . There were no significant differences in the risk of either coronary heart disease or venous thromboembolism between the two groups . CONCLUSIONS Tibolone reduced the risk of fracture and breast cancer and possibly colon cancer but increased the risk of stroke in older women with osteoporosis . ( Clinical Trials.gov number , NCT00519857 .
This meta- analysis shows that oral tibolone treatment significantly lowers circulating Lp(a ) levels in postmenopausal women .
INTRODUCTION Circulating lipoprotein ( a ) ( Lp(a ) ) is a recognized risk factor for cardiovascular disease ( CVD ) .
Tibolone , a synthetic steroid , may lower Lp(a ) levels ; however , evidence of the effects of tibolone on Lp(a ) still remain to be defined .
Therefore , we investigated the effects of tibolone treatment on circulating Lp(a ) levels in postmenopausal women .