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NCCTG Study Compares Venlafaxine and Progestational Agents in Reducing Hot Flashes: A Menopause Symptom

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By Armen Hareyan on May 31, 2005 - 1:25pm for eMaxHealth

Reducing The Symptoms of Menopause

Mayo Clinic researchers will outline current data comparing the effectiveness of two medicines, venlafaxine and a progestational agent, in combating hot flashes.

Previous studies have shown that both venlafaxine and progestational agents substantially decrease hot flashes. This NCCTG trial demonstrated that a single dose of the progestational agent, medroxyprogesterone acetate (MPA), alleviated hot flashes more than did the daily use of the oral antidepressant venlafaxine (Effexor). Three to four weeks after treatment began, researchers observed that MPA was more effective than venlafaxine. This difference became even more striking after six weeks of treatment, says Mayo medical oncologist Charles Loprinzi, M.D., Mayo Clinic in Rochester, Minn., the NCCTG study's lead investigator.

"This improved hot flash benefit appeared to last for at least six months following a single MPA dose, with almost three times as many patients still reporting a 90 percent hot flash reduction following MPA, versus patients receiving daily oral venlafaxine," says Dr. Loprinzi.

The findings reviewed in this presentation include data from 185 patients. Six weeks after treatment was started (compared to the baseline week), patients who received the single shot of MPA, versus those on venlafaxine, had greater reductions in median hot flash frequencies (85 percent vs. 52 percent reduction) and reductions in median hot flash scores (88 percent vs. 57 percent reduction).

Mayo researchers also noted that 24 percent of patients who received MPA reported no hot flashes after six weeks compared to 1 percent of venlafaxine patients. Patients on MPA also reported less trouble sleeping, less sleepiness, less constipation, less abnormal sweating and less hot flash distress than patients on venlafaxine.

The patients on venlafaxine had trends for less trouble than MPA patients with "controlling their feelings," less "feeling tense," and less "stress." Because the trial included participants with and without a history of breast cancer, these findings should benefit a very broad group of women experiencing difficulties with hot flashes.

Dr. Loprinzi and his colleagues note that recent reports of large clinical trials linking hormone therapy to an increased risk for cancer have caused concern about the use of estrogen therapy, given with or without progesterone.

"Given that it has taken tens of thousands of women, studied for decades, to understand the safety of estrogen or combined hormonal therapy, further definitive data regarding a single MPA dose is not likely to become available in the foreseeable future," says Dr. Loprinzi. "Therefore, decisions regarding whether to use, or not use, MPA for hot flashes will need to be made with less than definitive data. Available information suggests that a single 400 mg dose of MPA is safe and is a reasonable option to offer patients."

DISCLOSURE: This trial was sponsored by a grant from the National Cancer Institute and conducted by a network of researchers led by the NCCTG. Drug supply for the study was provided by Wyeth Pharmaceuticals and through an unrestricted grant from Upjohn. Based at Mayo Clinic in Rochester, Minn., NCCTG is a national clinical research group sponsored by the National Cancer Institute. NCCTG is a network of more than 400 community-based cancer treatment clinics in the United States, Canada and Mexico that work with Mayo Clinic to conduct clinical studies for advancing cancer treatment.

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Mayo Clinic - http://www.mayoclinic.org

Source: 
Mayo Clinic

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