Impact of anti-oestrogen therapy on lipoprotein(a) in postmenopausal women: a systematic review and meta-analysis of double-blind placebo-controlled clinical studies

Purpose The potential mechanisms of endocrine therapy for thrombosis remain currently unclear, and more studies are warranted for further investigation and elucidation. However, high plasma concentration of lipoprotein(a) (Lp(a)) is a recognized prothrombotic factor. The aim of our study was to syst...

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Bibliographic Details
Published in:Endocrine 2023-05, Vol.80 (2), p.292-302
Main Authors: Fogacci, Federica, Borghi, Claudio, Davinelli, Sergio, Scapagnini, Giovanni, Cicero, Arrigo F. G.
Format: Article
Language:English
Subjects:
Antiestrogens
Clinical trials
Diabetes
Double-blind studies
Endocrine therapy
Endocrinology
Estrogens
Female
Hormone Replacement Therapy
Humanities and Social Sciences
Humans
Internal Medicine
Lipoprotein(a)
Medicine
Medicine & Public Health
Meta- Analysis
multidisciplinary
Placebos
Post-menopause
Postmenopause
Randomized Controlled Trials as Topic
Science
Thrombosis
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Summary:Purpose The potential mechanisms of endocrine therapy for thrombosis remain currently unclear, and more studies are warranted for further investigation and elucidation. However, high plasma concentration of lipoprotein(a) (Lp(a)) is a recognized prothrombotic factor. The aim of our study was to systematically evaluate the effect of different anti-oestrogen therapy on plasma Lp(a) level in postmenopausal women. Methods A systematic literature search was conducted in multiple electronic databases to identify the randomized, double-blind, placebo-controlled clinical studies on this topic. Effect size for changes in Lp(a) was expressed as mean difference (MD) and 95% confidence intervals (CI). Results Data were pooled from 10 clinical trials comprising 24 treatment arms, which included 2049 women (1128 women in the active-treated arms and 921 women in the control arms). Meta-analysis of data suggested that anti-oestrogen therapy in women significantly reduced Lp(a) [MD = −5.92% (95%CI: −9.05%,−2.8%)]. Conclusions This observation is of both clinical and pathophysiological relevance, also in view that the identification of molecular determinants and cellular pathways implicated in Lp(a) synthesis and metabolism is still of concern as a critical issue in lipidology and CV prevention.
ISSN:1559-0100
1355-008X
1559-0100
DOI:10.1007/s12020-022-03287-2