title: Efficacy of a new 7-day transdermal sequential estradiol/levonorgestrel patch in women.
abstract: OBJECTIVE
  To investigate the efficacy and tolerability of a new 7-day transdermal sequential estradiol/levonorgestrel patch (Fem7 Combi; Merck KGaA; Germany), versus placebo, as hormone replacement therapy in menopausal women.
  
  
  METHODS
  A multicentre, randomized, clinical study consisting of a 3-week screening phase, a 12-week double-blind, placebo-controlled treatment phase, and a 12-week open, follow-up phase. Women aged 40-65 years with an intact uterus and menopausal complaints were randomized to either 2 weeks of an estradiol mono patch (50 microg per 24 h) followed by 2 weeks of an estradiol/levonorgestrel combination patch (50 microg/10 microg per 24 h), or a placebo patch, for three 28-day cycles. Changes in the Kupperman Index and the frequency of hot flushes were assessed.
  
  
  RESULTS
  The sequential use of a 7-day estradiol patch and a 7-day estradiol/levonorgestrel patch was superior to placebo in reducing menopausal symptoms, and was well tolerated. At the end of the treatment phase, there was a statistically significant reduction in the Kupperman Index score versus placebo (P<0.0001), and a statistically significant difference between groups in the proportion of patients with a reduction in the number of hot flushes (at least 50% versus baseline). During the open follow-up phase, there was a marked reduction in the Kupperman Index score and the number of hot flushes for patients switched from placebo to active study medication. The active medication was effective throughout the 1-week application period.
  
  
  CONCLUSIONS
  The new 7-day transdermal sequential estradiol/levonorgestrel patch was well tolerated, providing rapid and effective relief of menopausal symptoms. The addition of low-dose levonorgestrel did not influence the beneficial effects of estradiol.
authors.affiliation: University Gynecological Clinic, Ruprecht-Karl University, Vossstrasse 9, D-69115 Heidelberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: von Holst
authors.forename: Birgitt
authors.initials: B
authors.lastname: Salbach
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D005858:Germany; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage / Q000627:therapeutic use*; D008593:Menopause; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D004958:Estradiol; D016912:Levonorgestrel