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O3‐01‐03: Effects of hormone therapy on brain structure in recently postmenopausal women: A randomized controlled trial
Author(s) -
Kantarci Kejal,
Tosakulwong Nirubol,
Lesnick Timothy G.,
Zuk Samantha M.,
Gunter Jeffrey L.,
Gleason Carey E.,
Wharton Whitney,
Dowling N. Maritza,
Vemuri Prashanthi,
Senjem Matthew L.,
Shuster Lynne T.,
Bailey Kent R.,
Rocca Walter,
Jack Clifford R.,
Asthana Sanjay,
Miller Virginia M.
Publication year - 2015
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.07.238
Subject(s) - menopause , medicine , hormone therapy , placebo , hormone replacement therapy (female to male) , randomized controlled trial , dementia , estrogen , cognitive decline , randomization , magnetic resonance imaging , women's health initiative , postmenopausal women , breast cancer , testosterone (patch) , pathology , radiology , disease , alternative medicine , cancer
Background:Treatments to reduce the amyloid plaque burden in the aging, cognitively normal population may prevent or delay the development of dementia. Pittsburgh compound B (PiB) binds to amyloid plaque and provides a surrogate for amyloid b pathology using PET. PiB-PET retention is a frequent finding in the aging, cognitively normal population. We investigated whether the treatment of postmenopausalwomenwithmenopausal hormone therapy (MHT)would have an association with amyloid burden measured by PiB-PET. Methods:Participants were recruited from the Kronos Early Estrogen Prevention Study (KEEPS), which was a randomized, placebo controlled trial to evaluate cardiovascular effects of MHT in recently menopausal women. PiB imaging was performed on a subgroup of subjects about 7 years after initiating 4 years of MHTwhere women within 6-36 months of their last menses had been randomized to either oral conjugated equine estrogen (CEE), Premarin, 0.45mg/ day (N1⁄417); or transdermal 17b-estradiol (TE), Climara, 50mg/day (N1⁄421) (each with progesterone 200mg/day for 12 days/month) or placebo pills and patch (N1⁄430). Participants had full clinical and neuropsychometric assessments. PiB images from each group were compared after treatment using a global SUVr measurement as a continuous measure. Results: Positive PiB-PET scans were seen in 3(18%), 1(5%) and 1(3%) with median (range) SUVr’s of 1.27 (1.19, 1.76), 1.25 (1.12, 1.75), 1.28 (1.20, 1.44) in the CEE, TE, and placebo groups respectively. A trend for reduced PiB retention was seen in the TE group vs. placebo (p1⁄40.08). Among women who were APOE 4+ (N1⁄418), we observed differences in PiB retention between CEE vs. TE (p1⁄40.049) and TE vs. placebo (p1⁄40.055) groups. No significant differences were observed in APOE 4participants (n1⁄440). (Figure) Conclusions:These preliminary findings in a small number of women suggest an active role of TE for reducing amyloid brain deposition in postmenopausal women when treated for 4 years, shortly after menopause. These data may provide the rationale for a clinical trial to further investigate these findings in a larger population. These findings would support the observation that 17b-estradiol re-