Contemporary OB/GYN week in review: Fezolinetant, hormone therapy, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, September 16 - Friday, September 20, 2024), and click each link to read and watch anything you may have missed.

How fezolinetant revolutionizes non-hormonal menopause therapy

In an interview with Contemporary OB/GYN, Marla Shapiro, a professor at the University of Toronto and specialist in preventive medicine and public health, discussed the results of studies on fezolinetant, a treatment for menopause-related symptoms such as hot flashes and sleep disturbances.

The ability to fall and stay asleep and daytime functioning after sleep were the primary sleep functions evaluated. Both participants who initially had sleep issues and those who did not experienced improvements in sleep quality and next-day functioning when taking fezolinetant, especially at the 45 mg dose. The medication proved more effective than the placebo, with marked improvements by week 12, especially among those with initial sleep problems.

Watch here.

Matthew Nudy, MD, on hormone therapy and cardiovascular effects

In an interview, Matthew Nudy, MD, discussed the results of a study analyzing cardiovascular biomarkers in participants of the Women's Health Initiative hormone therapy clinical trials. The research focused on 2 groups: women who had undergone hysterectomies and received estrogen therapy, and women with intact uteruses who received a combination of estrogen and progestin. The objective of the study was to evaluate how these hormone therapies influenced cardiovascular biomarkers over a 6-year period.

One of the key findings was that both hormone therapy formulations—estrogen alone and estrogen plus medroxyprogesterone—reduced LDL cholesterol levels over time. "We found that both conjugated equine estrogen and conjugated equine estrogen plus medroxyprogesterone reduced LDL concentrations over the long term," Nudy explained. Additionally, the therapies had generally positive effects on several cardiovascular biomarkers, such as increasing HDL cholesterol and reducing total cholesterol, Lp(a), insulin, glucose concentrations, and insulin resistance (measured by Homa IR).

Watch here.

Pregnancy disorders linked to cardiovascular disease in menopausal women

In an interview with Contemporary OB/GYN, Marie Tan, a fourth-year medical student at Drexel University College of Medicine, discussed a study analyzing the association between pregnancy-related disorders and cardiovascular disease in menopausal women.

Interestingly, the study found that gestational hypertension, rather than preeclampsia, was significantly associated with cardiovascular disease risk. This finding was unexpected since previous studies and meta-analyses have typically indicated preeclampsia as a stronger predictor of cardiovascular disease. Tan’s study did not show a similar association for either preeclampsia or gestational diabetes.

Watch here.

Increase in ED visits for hypertensive disorders from 2006 to 2020 reported

A significant increase in emergency department (ED) visits for hypertensive disorders of pregnancy and the postpartum period (HDPP) occurred in the United States between 2006 and 2020, according to a recent study published in JAMA Network Open.

There were 656,711 HDPP-related ED encounters from 2006 to 2020, increasing from 31,623 in 2006 to 55,893 in 2020. Additionally, admission for HDPP increased from 17,338 in 2006 to 43,563 in 2020, with admission rates for HDPP at 54.8% and 77.9%, respectively. In comparison, admission rates for all other primary diagnoses remained stable.

Click here for the full article.

Study highlights variable efficacy of aspirin dosing during pregnancy

Administration of a single dose of aspirin during pregnancy is associated with plasma concentrations of salicylic acid, thromboxane suppression, and platelet inhibition, according to a recent study published in the American Journal of Obstetrics & Gynecology.

Urinary thromboxane was significantly reduced at the first follow-up visit when compared to baseline, with these changes decreasing in the third trimester. Mean serum thromboxane also decreased following aspirin use, but these reductions were not statistically significant and had significant variations.

Click here for the full article.