Bazedoxifene plus conjugated estrogens improve menopausal symptoms in postmenopausal women: a systematic review and meta-analysis

Abstract

Our aim is to evaluate the efficacy of bazedoxifene (BZA) plus conjugated estrogens (CE) on menopausal symptoms in postmenopausal women. A series of databases including PubMed, EMBASE, Medline, Web of science, China national knowledge internet and Wanfang database up to 31 October 2021 were searched, and randomized controlled trials (RCTs) of BZA/CE for menopausal symptoms were included. Seven RCTs involving 5431 patients were included in this study. Compared with placebo group, there were significantly reduce in daily number of hot flushes, daily number of moderate or severe hot flushes, the percentages of parabasal cells and the time to fall sleep when patients treated with BZA/CE. Besides, there were significant improvement in sleep disturbance and total MENQOL. However, no significant improvements in sleep adequacy were observed in the three groups. Furthermore, BZA 20 mg/CE 0.625 mg was more effective than BZA 20 mg/CE 0.45 mg in improving the menopausal symptoms. Therefore, both bazedoxifene 20 mg plus conjugated estrogens 0.45 mg and bazedoxifene 20 mg plus conjugated estrogens 0.625 mg could significantly improve the menopause-related symptoms and MENQOL in postmenopausal women, and the curative effects of BZA 20 mg/CE 0.625 mg were better than that of BZA 20 mg/CE 0.45 mg. These findings need to be further confirmed by more high-quality RCTs.

摘要

我们的目的是评估巴多昔芬( BZA )联合结合雌激素( CE )对绝经后妇女绝经症状的疗效。检索PubMed、EMBASE、Medline、Web of science、中国知网、万方数据库等一系列数据库,检索截止至2021年10月31日, 纳入BZA / CE治疗绝经症状的随机对照试验(RCTs)。本研究纳入了7项RCTs, 包括5431名患者。与安慰剂组相比,BZA / CE组患者每日潮热次数、每日中重度潮热次数、副基底层细胞百分比和入睡时间显著减少,睡眠障碍和MENQOL总分显著改善。但3组患者睡眠充分性均无明显改善。此外,BZA 20mg / CE 0.625mg在改善绝经症状方面比BZA 20mg / CE 0.45mg更有效。因此, BZA 20mg联合CE 0.45mg和BZA 20mg联合CE 0.625mg都能明显改善绝经后妇女的绝经相关症状和MENQOL, 而且BZA 20mg / CE 0.625mg的疗效优于BZA 20mg / CE 0.45mg。这些发现需要由更多高质量的RCTs来进一步证实。

Keywords:

• Menopause
• bazedoxifene
• estrogens
• Hot flushes
• sleep disturbance
• quality of life

关键词:

• 绝经
• 巴多昔芬
• 雌激素
• 潮热
• 睡眠障碍
• 生活质量

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Traditional Chinese Medicine Science and Technology Program of Zhejiang Province (2019ZQ007 and 2021ZA025), and the Health Science and Technology Project of Zhejiang Province (2021KY601).