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Clinical Summary

Hormone replacement therapy linked to reduced asthma risk in menopausal women

Takeaway

  • Current and previous use of hormone replacement therapy (HRT) and its subtypes (oestrogen-only and combined oestrogen/progestogen) were associated with a reduced risk of developing new-onset asthma in menopausal women.
  • Longer duration of HRT use was associated with a dose-response reduced risk of asthma onset.
Why this matters
  • Further prospective cohort studies are needed to confirm these findings.
  • There is also a need for mechanistic studies to examine the possible protective role of HRT in the pathogenesis of asthma in women.
Study design
  • This national, longitudinal study included 353,173 peri- and post-menopausal women (aged 45-70 years) from the Optimum Patient Care Database (2000-2016).
  • Association of HRT use, its subtypes and duration of use with the risk of developing asthma was evaluated.
  • Funding: Asthma UK and Health Data Research UK.
Key results
  • During 17 years of follow-up, 7614 new asthma cases were recorded (incidence rate, 5.7 [95% CI, 5.5-5.8] per 1000 person-years).
  • Compared with non-HRT use, previous use of any (adjusted HR [aHR], 0.83; 95% CI, 0.76-0.88), oestrogen-only (aHR, 0.89; 95% CI, 0.84-0.95) and combined oestrogen/progestogen (aHR, 0.82; 95% CI, 0.76-0.88) HRT was associated with a decreased risk of asthma onset.
  • Similarly, current use of any (aHR, 0.79; 95% CI, 0.74-0.85), oestrogen-only (aHR, 0.80; 95% CI, 0.73-0.87) and combined oestrogen/progestogen (aHR, 0.78; 95% CI, 0.70-0.87) HRT was associated with a reduced risk of asthma onset.
  • Duration of HRT use was associated with a decreased risk of asthma onset in a dose-response manner:
    • 1-2 years: aHR, 0.93; 95% CI, 0.87-0.99;
    • 3-4 years: aHR, 0.77; 95% CI, 0.70-0.84; and
    • >5 years: aHR, 0.71; 95% CI, 0.64-0.78.
Limitations
  • Menopausal status of females was based only on the ages of women.
  • Risk of residual confounding.

References


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