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The impact of tamoxifen on apolipoproteins and lipoprotein(a) levels: an updated meta-analysis of randomized

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Tamoxifen treatment in women was found to decrease lipoprotein(a) and apolipoprotein B levels, while increasing apolipoprotein A-I. This meta-analysis clarifies tamoxifen's impact on key lipid parameters.

Keywords:
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Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Evidence on tamoxifen's effects on lipoprotein(a) and apolipoproteins is inconsistent.
  • Tamoxifen is a widely used medication for hormone-sensitive breast cancer.

Purpose of the Study:

  • To provide an updated meta-analysis of randomized controlled trials (RCTs).
  • To clarify the impact of tamoxifen on lipoprotein(a), apolipoprotein A-I (ApoA-I), and apolipoprotein B (ApoB) levels.

Main Methods:

  • A comprehensive literature search identified eligible RCTs up to October 2024.
  • A random-effects model was employed for the meta-analysis.
  • Results were reported as weighted mean differences (WMD) with 95% confidence intervals (CI).

Main Results:

  • Tamoxifen significantly increased ApoA-I levels (WMD: 15.22 mg/dL).
  • Tamoxifen significantly decreased ApoB (WMD: -9.33 mg/dL) and lipoprotein(a) (WMD: -3.35 mg/dL) levels.
  • Reductions in lipoprotein(a) were more pronounced with treatment durations ≤24 weeks and doses ≥20 mg/day.

Conclusions:

  • Tamoxifen treatment demonstrably lowers lipoprotein(a) and ApoB levels in women.
  • Tamoxifen also leads to an increase in ApoA-I levels.
  • This meta-analysis strengthens the evidence base for tamoxifen's cardiovascular lipid effects.