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The Pharmaceutical Journal
Vol 269 No 7223 p666
9 November 2002

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Current Problems in Pharmacovigilance (more)
JAMA (more)

HRT safety message update in latest issue of MCA/CSM bulletin

The benefits of hormone replacement therapy over the short term still outweigh the risks for most women who take it, according to the latest safety update from the Medicines Control Agency and the Committee on Safety of Medicines.

The October issue of Current Problems in Pharmacovigilance (2002:28) points out that longer-term use of HRT is licensed for the prevention of osteoporosis. However, it states that patients should be aware of the increased incidence of some conditions following such long-term therapy, and of the alternative treatment options that are available for the prevention of osteoporosis. In addition, the bulletin recommends that individual risks and benefits should be reassessed annually with continued HRT use and that HRT should not be prescribed for the prevention of coronary heart disease.

This latest MCA and CSM safety update follows an examination of data from recent studies, which was prompted by the premature termination of a major American trial investigating the risk-benefit profile of HRT, earlier this year (PJ, 13 July, p43). Last month, a similar, British trial was also stopped early (PJ, 2 November, p633).

HRT could reduce Alzheimer's risk Previous use of hormone replacement therapy is associated with a reduced risk of Alzheimer's disease, American researchers have found (JAMA 2002;288:2123).

Their results showed that 2.4 per cent of prior users of HRT subsequently developed Alzheimer's disease, compared with 7.25 per cent of non-users (hazard ratio 0.59, confidence interval 0.36–0.96). However, there was no apparent benefit with current HRT use, unless treatment duration exceeded 10 years (hazard ratio 0.55, confidence interval 0.21–1.23). This study contradicts research reported in last week's Journal (PJ, 2 November, p633), suggesting that long-term HRT worsened memory in rats.