閉経後の患者における慢性疾患の主な予防のためのホルモン療法:米国予防サービスタスクフォースの勧告声明
, Carol M Mangione1, Michael J Barry2
1University of California, Los Angeles.
JAMA
|November 1, 2022
まとめ
閉経後の患者に慢性疾患を予防するためのホルモン療法には,純利益はありません. 米国予防サービス・タスクフォースは,この目的でエストロゲンまたは併用ホルモン療法を使用することを推奨しています.
科学分野:
- 生殖 健康
- 予防 医療
- 内分泌学
背景:
- 月経が止まると 慢性疾患のリスクが増加します
- 閉経後の個人は 心血管疾患,がん,骨粗鬆症などの リスクが高まります
- ホルモン療法は,閉経後の女性のこれらの慢性疾患を予防するためにしばしば考慮されます.
研究 の 目的:
- 閉経後の患者における慢性疾患の予防のための全身ホルモン療法の利害を評価する.
- ホルモン療法に関する2017年米国予防サービスタスクフォース (USPSTF) の勧告を更新する.
- 年齢やホルモン療法介入のタイミングによって結果が変化するかどうかを判断する.
主な方法:
- USPSTFによって体系的なレビューが委託されました.
- このレビューでは,慢性疾患の初次予防のために全身ホルモン療法 (経口または経皮) を評価した.
- このレビューでは,ホルモン療法を検討する無症状の閉経後の個人を検討した.
主要な成果:
- エストロゲンとプロゲスチンの併用療法では,子宮が整った閉経後の患者では,純利益は見られなかった.
- 子宮切除術を受けた閉経後の女性に対するエストロゲン単独療法も,純利益を示さなかった.
- これらの発見は,適度な確実性で成立します.
結論:
- USPSTFは,閉経後の患者における慢性疾患の予防に,エストロゲンとプロゲスチンの併用を推奨しない.
- USPSTFはまた,月経閉経後,子宮切除歴のある個人の慢性疾患の予防のためにエストロゲンを単独で使用することを推奨している.
- これは"D"の勧告であり, 純利益がないという証拠に基づいた強い反対を示しています.
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