Hormonsko nadomjesno liječenje i venske tromboembolije

Scientific paper - Original scientific paper

• Title (english): Hormone replacement therapy and venous thromboembolism
• Author: Dinka Pavičić Baldani
• Author: Lana Škrgatić
• Author: Velimir Šimunić
• Author: Vesna Elveđi Gašparović
• Author: Blaž Geršak
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Venous thromboembolism (VTE) is the most important side effect of using hormone replacement therapy (HRT). Biological and epidemiological studies have shown that oral administration of estrogen is associated with an increased risk of VTE compared to transdermal route of administration. Addition of progestogen to estrogen further increases the risk of VTE. Different pharmacological classes of progestogens differently contribute to the risk of VTE. Observational studies observed that the application of micronized progesterone and didrogesteron are safer regarding the risk of VTE compared to other progestins. These results should be further confirmed in the randomized studies. A personal or family history of VTE, existence of hereditary thrombophilia or/and multiple risk factors for VTE represent a strong contraindication to oral HRT use. In such persons the application of transdermal estrogen can be considered after careful individual evaluation of the benefits and risks. Transdermal estrogen should be also the first choice in overweight/obese women requiring HRT.

Abstract (croatian)

Venska tromboembolija (VTE) najvažniji je neželjeni učinak hormonskoga nadomjesnog liječenja (HNL). Biološke i epidemiološke studije pokazale su da oralna primjena estrogena nosi povišen rizik od nastanka VTE-a u odnosu na transdermalnu primjenu. Dodatak progestagena još povisuje rizik od nastanka VTE-a. Različite farmakološke klase progestagena drugačije pridonose riziku od nastanka VTE-a. Opservacijske su studije pokazale da je primjena mikroniziranog progesterona i didrogesterona sigurnija glede rizika od VTE-a u odnosu na druge progestine. Ove je rezultate nužno provjeriti randomiziranim studijama. Osobna ili obiteljska anamneza opterećena VTE-om, postojanje nasljedne trombofilije i/ili multiplih rizičnih čimbenika za nastanak VTE-a kontraindikacije su za uporabu HNL-a. U takvih se osoba može razmatrati primjena transdermalnog estrogena nakon pomne individualne procjene koristi i rizika. Transdermalno primijenjeni estrogeni također bi trebali biti prvi izbor u žena s prekomjernom tjelesnom masom, odnosno pretilosti koje trebaju primjenu HNL-a.

• Keywords (english): Administration, Cutaneous; Administration, Oral; Estrogen Replacement Therapy/adverse effects; Estrogens/adverse effects; Estrogens/therapeutic use; Female; Humans; Obesity/complications; Overweight/complications; Postmenopause; Progestins/adverse effects; Progestins/therapeutic use; Risk Factors; Thrombophilia/complications; Venous Thromboembolism/chemically induced
• Language: croatian
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 137, no. 1-2, pp. 34-40
• p-ISSN: 0024-3477
• URN:NBN: urn:nbn:hr:105:120882
• Publication: 2015-01
• Document URL: http://lijecnicki-vjesnik.hlz.hr/lijecnicki-vjesnik/hormonsko-nadomjesno-lijecenje-i-venske-tromboembolije/
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 09:29:45