Climodien (estradiol valerate 2 mg plus dienogest 2 mg) is safe and effective in the treatment of postmenopausal complaints.
OBJECTIVE
To evaluate the efficacy, safety and tolerability of continuous combined hormone replacement therapy (HRT) with Climodien (estradiol valerate 2 mg plus dienogest 2 mg).


METHODS
Open, multinational, multicenter, non-controlled phase III study.


METHODS
A total of 1501 women aged 52-65 years with postmenopausal symptoms of sufficient severity to require treatment.


METHODS
Eligible patients were treated with Climodien for 12 treatment cycles (48 weeks), with assessments of efficacy, safety and tolerability (adverse events) at 8, 24 and 48 weeks. Efficacy was assessed using the Kupperman index. Safety assessments included endovaginal sonography, safety endometrial biopsies, mammography, physical and gynecological examination, vital signs, prothrombotic factors and routine laboratory safety parameters.


RESULTS
The Kupperman index improved with increasing duration of treatment, accompanied by an improvement in self-reported patient well-being. Individual climacteric symptoms such as hot flushes and psychonervous disorders also improved. The most pronounced improvement was seen in women who had not previously used HRT. The incidence of breakthrough bleeding declined over time, resulting in complete amenorrhea in 86.2% of the patients after 12 cycles of treatment. Furthermore, total and low-density lipoprotein (LDL) cholesterol levels decreased and high-density lipoprotein (HDL) cholesterol levels increased. Decreases in alkaline phosphatase, pyridinoline and deoxypyridinoline demonstrated the inhibitory action of estradiol on bone resorption. Endometrial thickness remained almost constant, and the incidence of serious endometrial findings was similar to that in untreated women.


CONCLUSIONS
Continuous combined estrogen-progestin therapy with Climodien is effective, safe and well tolerated in postmenopausal women, with a profile and incidence of adverse events consistent with those of existing HRT preparations.
Gräser
T
T
Jenapharm GmbH & Co. KG, Drug Safety Department, Otto-Schott-S. 15, D-07745 Jena, Germany.
Römer
T
T
Wiedey
K D
KD
Janaud
A
A
D000368:Aged; D001862:Bone Resorption; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D005060:Europe; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D020249:Hormone Replacement Therapy; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008875:Middle Aged; D009277:Nandrolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D017060:Patient Satisfaction; D017698:Postmenopause; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D014592:Uterine Hemorrhage
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008074:Lipoproteins; D014280:Triglycerides; C023635:dienogest; D004958:Estradiol; D009277:Nandrolone; D005640:Follicle Stimulating Hormone; D002784:Cholesterol