Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms

Katherine A. Guthrie, Andrea Z. Lacroix, Kristine E. Ensrud, Hadine Joffe, Katherine M. Newton, Susan D. Reed, Bette Caan, Janet Carpenter, Lee S. Cohen, Ellen W. Freeman, Joseph C. Larson, Joann E. Manson, Kathy Rexrode, Todd Skaar, Barbara Sternfeld, Garnet L. Anderson

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: To describe the effects of six interventions for menopausal vasomotor symptoms relative to control in a pooled analysis, facilitating translation of the results for clinicians and symptomatic women. The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network tested these interventions in three randomized clinical trials. METHODS: An analysis of pooled individual-level data from three randomized clinical trials is presented. Participants were 899 perimenopausal and postmenopausal women with at least 14 bothersome vasomotor symptoms per week. Interventions included 10-20 mg escitalopram per day, nonaerobic yoga, aerobic exercise, 1.8 g per day omega-3 fatty acid supplementation, 0.5 mg low-dose oral 17-beta-estradiol (E2) per day, and 75 mg low-dose venlafaxine XR per day. The main outcome measures were changes from baseline in mean daily vasomotor symptom frequency and bother during 8-12 weeks of treatment. Linear regression models estimated differences in outcomes between each intervention and corresponding control group adjusted for baseline characteristics. Models included trial-specific intercepts, effects of the baseline outcome measure, and time. RESULTS: The 8-week reduction in vasomotor symptom frequency from baseline relative to placebo was similar for escitalopram at -1.4 per day (95% confidence interval [CI] -2.7 to -0.2), low-dose E2 at -2.4 (95% CI -3.4 to -1.3), and venlafaxine at -1.8 (95% CI -2.8 to -0.8); vasomotor symptom bother reduction was minimal and did not vary across these three pharmacologic interventions (mean -0.2 to -0.3 relative to placebo). No effects on vasomotor symptom frequency or bother were seen with aerobic exercise, yoga, or omega-3 supplements. CONCLUSION: These analyses suggest that escitalopram, low-dose E2, and venlafaxine provide comparable, modest reductions in vasomotor symptom frequency and bother among women with moderate hot flushes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00894543 (MsFLASH 01), NCT01178892 (MsFLASH 02), and NCT01418209 (MsFLASH 03).

Original languageEnglish
Pages (from-to)413-422
Number of pages10
JournalObstetrics and Gynecology
Volume126
Issue number2
DOIs
StatePublished - Aug 23 2015

Fingerprint

Citalopram
Yoga
Confidence Intervals
Linear Models
Randomized Controlled Trials
Placebos
Outcome Assessment (Health Care)
Exercise
Omega-3 Fatty Acids
Menopause
Estradiol
Clinical Trials
Control Groups
Health
Venlafaxine Hydrochloride
Therapeutics

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Guthrie, K. A., Lacroix, A. Z., Ensrud, K. E., Joffe, H., Newton, K. M., Reed, S. D., ... Anderson, G. L. (2015). Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms. Obstetrics and Gynecology, 126(2), 413-422. https://doi.org/10.1097/AOG.0000000000000927

Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms. / Guthrie, Katherine A.; Lacroix, Andrea Z.; Ensrud, Kristine E.; Joffe, Hadine; Newton, Katherine M.; Reed, Susan D.; Caan, Bette; Carpenter, Janet; Cohen, Lee S.; Freeman, Ellen W.; Larson, Joseph C.; Manson, Joann E.; Rexrode, Kathy; Skaar, Todd; Sternfeld, Barbara; Anderson, Garnet L.

In: Obstetrics and Gynecology, Vol. 126, No. 2, 23.08.2015, p. 413-422.

Research output: Contribution to journalArticle

Guthrie, KA, Lacroix, AZ, Ensrud, KE, Joffe, H, Newton, KM, Reed, SD, Caan, B, Carpenter, J, Cohen, LS, Freeman, EW, Larson, JC, Manson, JE, Rexrode, K, Skaar, T, Sternfeld, B & Anderson, GL 2015, 'Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms', Obstetrics and Gynecology, vol. 126, no. 2, pp. 413-422. https://doi.org/10.1097/AOG.0000000000000927
Guthrie, Katherine A. ; Lacroix, Andrea Z. ; Ensrud, Kristine E. ; Joffe, Hadine ; Newton, Katherine M. ; Reed, Susan D. ; Caan, Bette ; Carpenter, Janet ; Cohen, Lee S. ; Freeman, Ellen W. ; Larson, Joseph C. ; Manson, Joann E. ; Rexrode, Kathy ; Skaar, Todd ; Sternfeld, Barbara ; Anderson, Garnet L. / Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms. In: Obstetrics and Gynecology. 2015 ; Vol. 126, No. 2. pp. 413-422.
@article{13cd4012bad74707a6855298779a5f03,
title = "Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms",
abstract = "OBJECTIVE: To describe the effects of six interventions for menopausal vasomotor symptoms relative to control in a pooled analysis, facilitating translation of the results for clinicians and symptomatic women. The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network tested these interventions in three randomized clinical trials. METHODS: An analysis of pooled individual-level data from three randomized clinical trials is presented. Participants were 899 perimenopausal and postmenopausal women with at least 14 bothersome vasomotor symptoms per week. Interventions included 10-20 mg escitalopram per day, nonaerobic yoga, aerobic exercise, 1.8 g per day omega-3 fatty acid supplementation, 0.5 mg low-dose oral 17-beta-estradiol (E2) per day, and 75 mg low-dose venlafaxine XR per day. The main outcome measures were changes from baseline in mean daily vasomotor symptom frequency and bother during 8-12 weeks of treatment. Linear regression models estimated differences in outcomes between each intervention and corresponding control group adjusted for baseline characteristics. Models included trial-specific intercepts, effects of the baseline outcome measure, and time. RESULTS: The 8-week reduction in vasomotor symptom frequency from baseline relative to placebo was similar for escitalopram at -1.4 per day (95{\%} confidence interval [CI] -2.7 to -0.2), low-dose E2 at -2.4 (95{\%} CI -3.4 to -1.3), and venlafaxine at -1.8 (95{\%} CI -2.8 to -0.8); vasomotor symptom bother reduction was minimal and did not vary across these three pharmacologic interventions (mean -0.2 to -0.3 relative to placebo). No effects on vasomotor symptom frequency or bother were seen with aerobic exercise, yoga, or omega-3 supplements. CONCLUSION: These analyses suggest that escitalopram, low-dose E2, and venlafaxine provide comparable, modest reductions in vasomotor symptom frequency and bother among women with moderate hot flushes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00894543 (MsFLASH 01), NCT01178892 (MsFLASH 02), and NCT01418209 (MsFLASH 03).",
author = "Guthrie, {Katherine A.} and Lacroix, {Andrea Z.} and Ensrud, {Kristine E.} and Hadine Joffe and Newton, {Katherine M.} and Reed, {Susan D.} and Bette Caan and Janet Carpenter and Cohen, {Lee S.} and Freeman, {Ellen W.} and Larson, {Joseph C.} and Manson, {Joann E.} and Kathy Rexrode and Todd Skaar and Barbara Sternfeld and Anderson, {Garnet L.}",
year = "2015",
month = "8",
day = "23",
doi = "10.1097/AOG.0000000000000927",
language = "English",
volume = "126",
pages = "413--422",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms

AU - Guthrie, Katherine A.

AU - Lacroix, Andrea Z.

AU - Ensrud, Kristine E.

AU - Joffe, Hadine

AU - Newton, Katherine M.

AU - Reed, Susan D.

AU - Caan, Bette

AU - Carpenter, Janet

AU - Cohen, Lee S.

AU - Freeman, Ellen W.

AU - Larson, Joseph C.

AU - Manson, Joann E.

AU - Rexrode, Kathy

AU - Skaar, Todd

AU - Sternfeld, Barbara

AU - Anderson, Garnet L.

PY - 2015/8/23

Y1 - 2015/8/23

N2 - OBJECTIVE: To describe the effects of six interventions for menopausal vasomotor symptoms relative to control in a pooled analysis, facilitating translation of the results for clinicians and symptomatic women. The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network tested these interventions in three randomized clinical trials. METHODS: An analysis of pooled individual-level data from three randomized clinical trials is presented. Participants were 899 perimenopausal and postmenopausal women with at least 14 bothersome vasomotor symptoms per week. Interventions included 10-20 mg escitalopram per day, nonaerobic yoga, aerobic exercise, 1.8 g per day omega-3 fatty acid supplementation, 0.5 mg low-dose oral 17-beta-estradiol (E2) per day, and 75 mg low-dose venlafaxine XR per day. The main outcome measures were changes from baseline in mean daily vasomotor symptom frequency and bother during 8-12 weeks of treatment. Linear regression models estimated differences in outcomes between each intervention and corresponding control group adjusted for baseline characteristics. Models included trial-specific intercepts, effects of the baseline outcome measure, and time. RESULTS: The 8-week reduction in vasomotor symptom frequency from baseline relative to placebo was similar for escitalopram at -1.4 per day (95% confidence interval [CI] -2.7 to -0.2), low-dose E2 at -2.4 (95% CI -3.4 to -1.3), and venlafaxine at -1.8 (95% CI -2.8 to -0.8); vasomotor symptom bother reduction was minimal and did not vary across these three pharmacologic interventions (mean -0.2 to -0.3 relative to placebo). No effects on vasomotor symptom frequency or bother were seen with aerobic exercise, yoga, or omega-3 supplements. CONCLUSION: These analyses suggest that escitalopram, low-dose E2, and venlafaxine provide comparable, modest reductions in vasomotor symptom frequency and bother among women with moderate hot flushes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00894543 (MsFLASH 01), NCT01178892 (MsFLASH 02), and NCT01418209 (MsFLASH 03).

AB - OBJECTIVE: To describe the effects of six interventions for menopausal vasomotor symptoms relative to control in a pooled analysis, facilitating translation of the results for clinicians and symptomatic women. The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network tested these interventions in three randomized clinical trials. METHODS: An analysis of pooled individual-level data from three randomized clinical trials is presented. Participants were 899 perimenopausal and postmenopausal women with at least 14 bothersome vasomotor symptoms per week. Interventions included 10-20 mg escitalopram per day, nonaerobic yoga, aerobic exercise, 1.8 g per day omega-3 fatty acid supplementation, 0.5 mg low-dose oral 17-beta-estradiol (E2) per day, and 75 mg low-dose venlafaxine XR per day. The main outcome measures were changes from baseline in mean daily vasomotor symptom frequency and bother during 8-12 weeks of treatment. Linear regression models estimated differences in outcomes between each intervention and corresponding control group adjusted for baseline characteristics. Models included trial-specific intercepts, effects of the baseline outcome measure, and time. RESULTS: The 8-week reduction in vasomotor symptom frequency from baseline relative to placebo was similar for escitalopram at -1.4 per day (95% confidence interval [CI] -2.7 to -0.2), low-dose E2 at -2.4 (95% CI -3.4 to -1.3), and venlafaxine at -1.8 (95% CI -2.8 to -0.8); vasomotor symptom bother reduction was minimal and did not vary across these three pharmacologic interventions (mean -0.2 to -0.3 relative to placebo). No effects on vasomotor symptom frequency or bother were seen with aerobic exercise, yoga, or omega-3 supplements. CONCLUSION: These analyses suggest that escitalopram, low-dose E2, and venlafaxine provide comparable, modest reductions in vasomotor symptom frequency and bother among women with moderate hot flushes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00894543 (MsFLASH 01), NCT01178892 (MsFLASH 02), and NCT01418209 (MsFLASH 03).

UR - http://www.scopus.com/inward/record.url?scp=84937707877&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937707877&partnerID=8YFLogxK

U2 - 10.1097/AOG.0000000000000927

DO - 10.1097/AOG.0000000000000927

M3 - Article

VL - 126

SP - 413

EP - 422

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 2

ER -