Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women: A Systematic Review with a Network Meta-analysis of Randomized Controlled Trials
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: Atrophic vaginitis (AV), which is common in postmenopausal women, is characterized by vaginal dryness, dyspareunia, and discomfort. There are a variety of therapeutic agents for the treatment of AV, besides hormone replacement therapy. We performed this systematic review to compare the effectiveness of various therapies for symptom improvement in AV patients. Methods: We searched the Cochrane Library, EMBASE, MEDLINE, and other literature (Google Scholar, Web of Science, and hand search) for studies published between January 2010 and March 2015. AV was evaluated by the following outcomes: vaginal pH, dyspareunia, vaginal dryness, or cytological change (endometrial thickness, percentages of superficial cells and parabasal cells). They measured treatment efficacy with various outcomes pertaining to AV symptoms. Results: Meta-analysis suggested that ospemifene was effective against dyspareunia, vaginal dryness, endometrial thickness, and percentage changes in superficial and parabasal cells. Vaginal pH was most affected by soy isoflavone vaginal gel. Ospemifene was effective for AV symptoms. Conclusions: This systematic review compared the effects of several therapeutic agents on symptoms of AV through a network meta-analysis. This study provides objective evidence for clinical treatment and efficacy management in AV. (J Menopausal Med 2018;24:1-10)
Abstract
Objectives: Atrophic vaginitis (AV), which is common in postmenopausal women, is characterized by vaginal dryness, dyspareunia, and discomfort. There are a variety of therapeutic agents for the treatment of AV, besides hormone replacement therapy. We performed this systematic review to compare the effectiveness of various therapies for symptom improvement in AV patients. Methods: We searched the Cochrane Library, EMBASE, MEDLINE, and other literature (Google Scholar, Web of Science, and hand search) for studies published between January 2010 and March 2015. AV was evaluated by the following outcomes: vaginal pH, dyspareunia, vaginal dryness, or cytological change (endometrial thickness, percentages of superficial cells and parabasal cells). They measured treatment efficacy with various outcomes pertaining to AV symptoms. Results: Meta-analysis suggested that ospemifene was effective against dyspareunia, vaginal dryness, endometrial thickness, and percentage changes in superficial and parabasal cells. Vaginal pH was most affected by soy isoflavone vaginal gel. Ospemifene was effective for AV symptoms. Conclusions: This systematic review compared the effects of several therapeutic agents on symptoms of AV through a network meta-analysis. This study provides objective evidence for clinical treatment and efficacy management in AV. (J Menopausal Med 2018;24:1-10)
참고문헌 (20)
- Nappi RE, "The clinical relevance of the effect of ospemifene on symptoms of vulvar and vaginal atrophy", Climacteric, 18, pp.233~240 (2015)[DOI]
- Cui Y, "The efficacy and safety of ospemifene in treating dyspareunia associated with postmenopausal vulvar and vaginal atrophy: a systematic review and meta-analysis", J Sex Med, 11, pp.487~497 (2014)[DOI]
- Goldstein I, "Multidisciplinary overview of vaginal atrophy and associated genitourinary symptoms in postmenopausal women", Sex Med, 1, pp.44~53 (2013)[DOI]
- 김현경, "The Recent Review of the Genitourinary Syndrome of Menopause", 대한폐경학회지, 21(2), pp.65~71 (2015), 대한폐경학회
- Lethaby A, "Local oestrogen for vaginal atrophy in postmenopausal women", Cochrane Database Syst Rev (2016)
- 이해혁, "Expression of Ezrin in Vagina Cells of Postmenopausal Rats after Dietary Administration of Omega-3 Fatty Acid Formula", 대한폐경학회지, 20(3), pp.97~103 (2014), 대한폐경학회
- Santen RJ, "Treatment of urogenital atrophy with low-dose estradiol: preliminary results", Menopause, 9, pp.179~187 (2002)[DOI]
- Wills S, "Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator", J Oncol Pract, 8, pp.144~148 (2012)[DOI]
- 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]
- 신재준, "Ospemifene: A Novel Option for the Treatment of Vulvovaginal Atrophy", 대한폐경학회지, 23(2), pp.79~84 (2017), 대한폐경학회
- Jaisamrarn U, "Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy", Climacteric, 16, pp.347~355 (2013)[DOI]
- Lima SM, "Effects of Glycine max (L.) Merr. soy isoflavone vaginal gel on epithelium morphology and estrogen receptor expression in postmenopausal women: a 12-week, randomized, double-blind, placebo-controlled trial", Maturitas, 78, pp.205~211 (2014)[DOI]
- Larmo PS, "Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebocontrolled study", Maturitas, 79, pp.316~321 (2014)[DOI]
- 김석환, "Rejuvenation Using Platelet-rich Plasma and Lipofilling for Vaginal Atrophy and Lichen Sclerosus", 대한폐경학회지, 23(1), pp.63~68 (2017), 대한폐경학회
- DeGregorio MW, "Ospemifene: a firstin-class, non-hormonal selective estrogen receptor modulator approved for the treatment of dyspareunia associated with vulvar and vaginal atrophy", Steroids, 90, pp.82~93 (2014)[DOI]
- Constantine G, "Female sexual function improved with ospemifene in postmenopausal women with vulvar and vaginal atrophy: results of a randomized, placebo-controlled trial", Climacteric, 18, pp.226~232 (2015)[DOI]
- Cano A, "The therapeutic effect of a new ultra low concentration estriol gel formulation (0.005% estriol vaginal gel) on symptoms and signs of postmenopausal vaginal atrophy: results from a pivotal phase III study", Menopause, 19, pp.1130~1139 (2012)[DOI]
- Bachmann GA, "Ospemifene effectively treats vulvovaginal atrophy in postmenopausal women: results from a pivotal phase 3 study", Menopause, 17, pp.480~486 (2010)
- Portman D, "Ospemifene, a non-oestrogen selective oestrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: a randomised, placebo-controlled, phase III trial", Maturitas, 78, pp.91~98 (2014)[DOI]
- Portman DJ, "Ospemifene, a novel selective estrogen receptor modulator for treating dyspareunia associated with postmenopausal vulvar and vaginal atrophy", Menopause, 20, pp.623~630 (2013)[DOI]