The use of estrogen among women with menopause and a uterus could increase the risk of endometrial cancer unless combined with progestin to “oppose” the estrogen.
Progestin seems to increase the risk of breast cancer relative to placebo or taking estrogen therapy.
It is possible that using a selective estrogen receptor modulator (SERM) instead of progestin to oppose estrogen could mitigate the increased risk of endometrial cancer associated with estrogen therapy without increasing the risk of breast cancer.
Bazedoxifene (BZA) is a SERM that was developed as an estrogen antagonist in breast and endometrial tissue. Combined with conjugated estrogens (CE/BZA), it is the first approved hormone therapy for women with menopause.
The uptake of CE/BZA in Europe has been low, with most women exposed to CE/BZA located in the United States. Evidence regarding the safety of CE/BZA is limited to preclinical studies and clinical trials.
In this symposium Prof Bassel Wattar and Prof Vikram Talaulikar discuss the findings of a large scale propensity score observational study by Hoffman et al which evaluated safety and efficacy of Conjugated estrogens/bazedoxifene (Duavee) compared to estrogen/progestin combination hormone therapy among women with menopause in the United States.
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