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Author Topic: BMS Response: Cochrane review - HRT for preventing CVD in post-menopausal women  (Read 4109 times)

Emma

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BMS Response – Cochrane review “Hormone therapy for preventing cardiovascular disease in post-menopausal women”

This will be making the news this morning (10th March 2015)
See the British Menopause Society (BMS) Response here:
http://www.menopausematters.co.uk/newsitem.php?recordID=160/BMS-Response-Cochrane-review-Hormone-therapy-for-preventing-cardiovascular-disease-in-post-menopausal-women
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Extremely busy Forum Administrator - please excuse my brevity.

dahliagirl

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Thanks - I heard this on the radio this morning and thought 'Oh dear - here we go again'.

It is reassuring and informative.
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Hurdity

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Thanks for posting this and especially the response  :)

What I don't understand about any of this is the value of doing these "meta-analyses" ie combining data from a whole lot of studies and trials with different experimental design, and hope to come out with a valid conclusion. I mean - these data still include the WHI study which has been reported to be flawed and the data re-analysed. I haven't read this report in detail (it's long!) and nor do I know the details of all the individual studies, but is it the case that subject to all the inclusion criteria etc the summary findings presented are from analysis of all the data combined as if they were one large trial? That's how I interpret it.

Of particular importance I would have thought from what I can see is: 1) they have only included oral HRT 2) there is no distinction between estradiol, conjugated equine oestrogens, nor between progesterone and types of synthetic progestogen ie it's a very broad brush over-generalised analysis where the subtleties may be lost, and important data excluded.

Surely it is these factors (mode of delivery, type of oestrogen and progestogen) that could give rise to crucially different conclusions, and where later studies which specifically address/investigate these distinctions or which look at transdermal oestrogen and progesterone - which although much smaller (in trial size) may have different, even more favourable outcomes?

I would love to hear an expert view on these specific points as I may be misinterpreting?

I also don't like the way the authors ( of the Cochrane Review) changed the name of the treatement to "Hormone Therapy" and for this reason:

"The term 'hormone replacement therapy' has been replaced by 'hormone therapy' as the older term infers that hormone therapy is replacing the function of a defective organ"   ... ( btw they do mean "imply" not "infer" of course!!)

Organ? Ovaries? I think mine are most definitely defective at 61.....

Hurdity
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Joyce

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Very reassuring. But will GPs pay any heed?
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GeordieGirl

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Of particular importance I would have thought from what I can see is: 1) they have only included oral HRT 2) there is no distinction between estradiol, conjugated equine oestrogens, nor between progesterone and types of synthetic progestogen ie it's a very broad brush over-generalised analysis where the subtleties may be lost, and important data excluded.

Surely it is these factors (mode of delivery, type of oestrogen and progestogen) that could give rise to crucially different conclusions, and where later studies which specifically address/investigate these distinctions or which look at transdermal oestrogen and progesterone - which although much smaller (in trial size) may have different, even more favourable outcomes?

I would love to hear an expert view on these specific points as I may be misinterpreting?

Totally agree -  when there are so many different forms / combinations / application methods and indeed doses, can their results really be held up as representative for HRT or BHRT as whole?

GGx 


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