Use of HRT Patches Lowers Risk of Gall Bladder Disease Versus Oral Therapy

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Title: Use of HRT Patches Lowers Risk of Gall Bladder Disease Versus Oral Therapy
URL: http://www.pslgroup.com/dg/2256FA.htm
Doctor's Guide
July 10, 2008

LONDON -- July 10, 2008 -- Use of hormone replacement therapy (HRT) increases the risk of gallbladder disease but the effects are less with transdermal HRT or gels compared with HRT given orally, according to a study published today on BMJ.com.

Until now, there has been no assessment of whether the risk of gallbladder disease varies according to the method of administration or type of HRT a woman is taking.

Bette Liu, MD, University of Oxford, Oxford, United Kingdom, and colleagues, reviewed data from the Million Women Study involving over 1.3 million women from the UK aged 50 years or older (mean age 56).

After an average follow-up time of 6 years, 19,889 women were admitted to hospital with gallbladder disease and 17,190 (86%) had a cholecystectomy.

They found that compared to women who had never taken HRT, all women using HRT had an increased risk of developing gallbladder disease, with a relative risk of 1.64 (95% confidence interval [CI], 1.58-1.69)

Furthermore, women taking HRT in a transdermal or gel form were less likely to be admitted for gallbladder disease and less likely to have a cholecystectomy than the women taking oral therapy (P < .001).

Hospital admission rates per 100 women over 5 years for cholecystectomy were 1.1 for women who had never used HRT, 1.3 for women using the HRT patch or gel, and 2.0 for women using the oral form of HRT.

The increased risk of gallbladder disease gradually decreased after use of HRT stopped (trend P = .004). However, 10 years after stopping, the risk remained greater than in women who had never used HRT.

"For women who choose to use hormone replacement therapy, 1 cholecystectomy could be avoided for every 140 users of transdermal therapy rather than oral therapy over a 5-year period," the authors wrote.

The authors suggest that the reason for the difference in risk of developing gallbladder disease between oral and transdermal HRT might be because of the different way oestrogen is absorbed.

SOURCE: BMJ (British Medical Journal)

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