Effects of tibolone on fibrinogen and antithrombin III: A systematic review and meta-analysis of controlled trials

Research output: Contribution to journalArticle

Authors

  • Małgorzata Bała
  • Amirhossein Sahebkar
  • Sorin Ursoniu
  • Maria-Corina Serban
  • Anetta Undas
  • Dimitri P. Mikhailidis
  • Jacek Rysz
  • Maciej Banach

Colleges, School and Institutes

External organisations

  • Department of Hygiene and Dietetics, Jagiellonian University Medical College
  • Biotechnology Research Center, Mashhad University of Medical Sciences
  • Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia
  • Department of Functional Sciences, Discipline of Public Health, “Victor Babes” University of Medicine and Pharmacy
  • Department of Functional Sciences, Discipline of Pathophysiology, “Victor Babes” University of Medicine and Pharmacy
  • Institute of Cardiology, Jagiellonian University Medical College
  • University College London
  • Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz
  • Polish Mother’s Memorial Hospital Research Institute
  • Cardiovascular Research Centre, University of Zielona Gora

Abstract

Tibolone is a synthetic steroid with estrogenic, androgenic and progestogenic activity, but the evidence regarding its effects on fibrinogen and antithrombin III (ATIII) has not been conclusive. We assessed the impact of tibolone on fibrinogen and ATIII through a systematic review and meta-analysis of available randomized controlled trials (RCTs). The search included PUBMED, Web of Science, Scopus, and Google Scholar (up to January 31st, 2016) to identify controlled clinical studies investigating the effects of oral tibolone treatment on fibrinogen and ATIII. Overall, the impact of tibolone on plasma fibrinogen concentrations was reported in 10 trials comprising 11 treatment arms. Meta-analysis did not suggest a significant reduction of fibrinogen levels following treatment with tibolone (WMD: −5.38%, 95% CI: −11.92, +1.16, p = 0.107). This result was robust in the sensitivity analysis and not influenced after omitting each of the included studies from meta-analysis. When the studies were categorized according to the duration of treatment, there was no effect in the subsets of trials lasting either <12 months (WMD: −7.64%, 95% CI: −16.58, +1.29, p = 0.094) or ≥12 months (WMD: −0.62%, 95% CI: −8.40, +7.17, p = 0.876). With regard to ATIII, there was no change following treatment with tibolone (WMD: +0.74%, 95% CI: −1.44, +2.93, p = 0.505) and this effect was robust in sensitivity analysis. There was no differential effect of tibolone on plasma ATIII concentrations in trials with either <12 months (WMD: +2.26%, 95% CI: −3.14, +7.66, p = 0.411) or ≥ 12 months (WMD: +0.06%, 95% CI: −1.16, +1.28, p = 0.926) duration. Consistent with the results of subgroup analysis, meta-regression did not suggest any significant association between the changes in plasma concentrations of fibrinogen (slope: +0.40; 95% CI: −0.39, +1.19; p = 0.317) and ATIII (slope: −0.17; 95% CI: −0.54, +0.20; p = 0.374) with duration of treatment. In conclusion, meta-analysis did not suggest a significant reduction of fibrinogen and ATIII levels following treatment with tibolone.

Details

Original languageEnglish
Pages (from-to)64-73
JournalPharmacological Research
Volume124
Early online date29 Jul 2017
Publication statusPublished - 1 Oct 2017

Keywords

  • antithrombin III , fibrinogen , postmenopausal women , tibolone