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Tissue-Selective Estrogen Complex and Breast

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초록

Although estrogen-progestin therapy has traditionally been standard care for postmenopausal women with an intact uterus experiencing bothersome menopausal symptoms, concerns about side effects related to menopausal hormone therapy (MHT) have led to a dramatic decrease in MHT use over recent decades. As many MHT side effects are now believed to be associated with the progestin component of MHT, efforts have been made to develop a progestin-free alternative to conventional MHT. Recently, a tissue-selective estrogen complex (TSEC), a combination of conjugated estrogen and bazedoxifene, was developed as a progestin-free MHT and is now approved and used worldwide for the relief of vasomotor symptoms and the prevention of bone loss in postmenopausal women. Replacement of synthetic progestin with bazedoxifene could allow more favorable safety profiles, such as those for pain or tenderness, mammographic density, and cancer incidence, for the breast. This review examined the effects of the TSEC on breasts and demonstrated evidence from preclinical and clinical studies supporting TSEC use in clinical practice.

Abstract

Although estrogen-progestin therapy has traditionally been standard care for postmenopausal women with an intact uterus experiencing bothersome menopausal symptoms, concerns about side effects related to menopausal hormone therapy (MHT) have led to a dramatic decrease in MHT use over recent decades. As many MHT side effects are now believed to be associated with the progestin component of MHT, efforts have been made to develop a progestin-free alternative to conventional MHT. Recently, a tissue-selective estrogen complex (TSEC), a combination of conjugated estrogen and bazedoxifene, was developed as a progestin-free MHT and is now approved and used worldwide for the relief of vasomotor symptoms and the prevention of bone loss in postmenopausal women. Replacement of synthetic progestin with bazedoxifene could allow more favorable safety profiles, such as those for pain or tenderness, mammographic density, and cancer incidence, for the breast. This review examined the effects of the TSEC on breasts and demonstrated evidence from preclinical and clinical studies supporting TSEC use in clinical practice.

참고문헌 (22)

  1. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel, "The 2017 hormone therapy position statement of The North American Menopause Society", Menopause, 24, pp.728~753 (2017)
  2. Rossouw JE, "Risks and benefits of estrogen plus progestin in healthy postmenopausal women : principal results from the Women's Health Initiative randomized controlled trial", JAMA, 288, pp.321~333 (2002)
  3. Anderson GL, "Effects of conjugated equine estrogen in postmenopausal women with hysterectomy : the Women's Health Initiative randomized controlled trial", JAMA, 291, pp.1701~1712 (2004)
  4. Peano BJ, "Effects of various selective estrogen receptor modulators with or without conjugated estrogens on mouse mammary gland", Endocrinology, 150, pp.1897~1903 (2009)
  5. Song Y, "Effects of the conjugated equine estrogen", bazedoxifene tissue-selective estrogen complex(TSEC)on mammary gland and breast cancer in mice, 2012, pp.153, 5706~5715
  6. Ethun KF, "Effects of bazedoxifene acetate with and without conjugated equine estrogens on the breast of postmenopausal monkeys", Menopause, 19, pp.1242~1252 (2012)
  7. Berrodin TJ, "Differential biochemical and cellular actions of Premarin estrogens : distinct pharmacology of bazedoxifene-conjugated estrogens combination", Mol Endocrinol, 23, pp.74~85 (2009)
  8. Chang KC, "Gene expression profiling studies of three SERMs and their conjugated estrogen combinations in human breast cancer cells : insights into the unique antagonistic effects of bazedoxifene on conjugated estrogens", J Steroid Biochem Mol Biol, 118, pp.117~124 (2010)
  9. Song Y, "Inhibitory effects of a bazedoxifene", conjugated equine estrogen combination on human breast cancer cells in vitro, 2013, pp.154, 656~665
  10. Madak-Erdogan Z, "Differential utilization of nuclear and extranuclear receptor signaling pathways in the actions of estrogens, SERMs, and a tissue-selective estrogen complex(TSEC)", J Steroid Biochem Mol Biol, 158, pp.198~206 (2016)
  11. Crandall CJ, "Breast tenderness and breast cancer risk in the estrogen plus progestin and estrogen-alone women's health initiative clinical trials", Breast Cancer Res Treat, 132, pp.275~285 (2012)
  12. Pinkerton JV, "Effects of bazedoxifene", conjugated estrogens on the endometrium and bone : a randomized trial, 2014, pp.99, E189~E198
  13. Lobo RA, "Evaluation of bazedoxifene", conjugated estrogens for the treatment of menopausal symptoms and effects on metabolic parameters and overall safety profile, 2009, pp.92, 1025~1038
  14. Pinkerton JV, "Relief of vasomotor symptoms with the tissue-selective estrogen complex containing bazedoxifene", conjugated estrogens : a randomized, controlled trial, 2009, pp.16, 1116~1124
  15. Kagan R, "A randomized, placebo-and active-controlled trial of bazedoxifene", conjugated estrogens for treatment of moderate to severe vulvar, Menopause, pp.2010, 17[DOI]
  16. Mirkin S, "Effects of bazedoxifene", conjugated estrogens on endometrial safety and bone in postmenopausal women, 2013, pp.16, 338~346
  17. Kim SE, "Tissue-selective estrogen complex for women who experience breast discomfort or vaginal bleeding when on hormone therapy", Menopause, 26, pp.383~386 (2019)
  18. Boyd NF, "Mammographic breast density as an intermediate phenotype for breast cancer", Lancet Oncol, 6, pp.798~808 (2005)
  19. McTiernan A, "Estrogen-plus-progestin use and mammographic density in postmenopausal women : Women's Health Initiative randomized trial", J Natl Cancer Inst, 97, pp.1366~1376 (2005)
  20. Harvey JA, "Breast density changes in a randomized controlled trial evaluating bazedoxifene", conjugated estrogens, 2013, pp.20, 138~145
  21. Pinkerton JV, "Breast effects of bazedoxifene-conjugated estrogens : a randomized controlled trial", Obstet Gynecol, 121, pp.959~968 (2013)
  22. Mirkin S, "Gynecologic safety of conjugated estrogens plus bazedoxifene : pooled analysis of five phase 3 trials", J Womens Health (Larchmt), 25, pp.431~442 (2016)

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