Comparison of efficacy and local tolerability of estradiol metered-dose transdermal spray to estradiol patch in a network meta-analysis.
OBJECTIVE
Transdermal hormone replacement therapy is preferred for menopausal vasomotor symptoms. Our purpose was to compare the efficacy and local tolerability of a patch and a metered-dose transdermal spray that have never been directly compared.


METHODS
The relative change in the number of hot flushes between baseline and week 12 was selected as an efficacy indicator and the frequency of local skin reactions as a tolerability indicator. A network meta-analysis was performed to compare efficacy. Application site tolerability was compared descriptively.


RESULTS
Overall 46 studies were identified. In the efficacy analysis, eight active treatment arms and a placebo arm were determined based on the estradiol daily dose (from 14 μg to 50 μg). All but one had a significantly higher effect on relative change in the number of hot flushes than did the placebo. We found no evidence for different efficacy of the patch and the metered-dose transdermal spray. The latter performed better in terms of local skin reactions.


CONCLUSIONS
The patch and the metered-dose transdermal spray seem to have the same efficacy on vasomotor symptoms in estradiol hormone replacement. The local tolerability of the metered-dose transdermal spray is favorable.
a Syreon Research Institute , Budapest , Hungary ;
G
G
Kovács
a Syreon Research Institute , Budapest , Hungary ;
T
T
Zelei
a Syreon Research Institute , Budapest , Hungary ;|b Department of Health Policy and Health Economics, Faculty of Social Sciences , Eötvös Loránd University , Budapest , Hungary.
Z
Z
Vokó
D000279:Administration, Cutaneous; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
D004958:Estradiol
Estradiol; efficacy; local tolerability; metered-dose transdermal spray; network meta-analysis; patch; safety