TY - JOUR

T1 - Inhaled anti-asthma therapies following hormone therapy in women

T2 - a nationwide cohort study

AU - Hansen, Erik Soeren Halvard

AU - Aasbjerg, Kristian

AU - Moeller, Amalie Lykkemark

AU - Meaidi, Amani

AU - Gade, Elisabeth Juul

AU - Torp-Pedersen, Christian

AU - Backer, Vibeke

N1 - Publisher Copyright: © The authors 2022.

PY - 2022

Y1 - 2022

N2 - Research question Does menopausal hormone therapy (HT) with exogenous oestrogens and progestogens change the use of inhaled anti-asthma medications in women with asthma? Methods In a population-based matched cohort study using the Danish registries, we included women with asthma aged 45–65 years from 1 June 1995 to 30 June 2018. We investigated whether HT with oestrogen and/or progestogens was associated with changes in use of inhaled anti-asthma therapies in the 12 months following initiation. We used exposure density matching to match exposed subjects with unexposed subjects on age, household income and level of education. An exposed subject was defined as receiving HT. We calculated mean dose of medications and odds ratios of increases in the 12 months following HT initiation. Results We included 139 483 women with asthma, of whom 116 014 (83.2%) were unexposed subjects and 23 469 (16.8%) exposed subjects. Mean±SD age was 53.0±5.2 years. Initiation of HT was not consistently associated with increased mean doses of inhaled corticosteroids (ICS), or long-and short-acting β2-agonists. Women receiving systemic oestrogens had increased odds ratios of large increases (>100 µg) in ICS at 6 months (OR 1.09; 95% CI 1.04–1.13; p<0.001) and 9 months (OR 1.07; 95% CI 1.03–1.12; p<0.001). Progestogens were protective against increases in ICS at 6 and 9 months (OR 0.87; 95% CI 0.82–0.93; p<0.001; and OR 0.86; 95% CI 0.81–0.91; p<0.001). Conclusion Initiation of HT did not change the use of inhaled medications in asthma. However, detrimental effects of oestrogen, as well as beneficial effects of progestogens, cannot be excluded.

AB - Research question Does menopausal hormone therapy (HT) with exogenous oestrogens and progestogens change the use of inhaled anti-asthma medications in women with asthma? Methods In a population-based matched cohort study using the Danish registries, we included women with asthma aged 45–65 years from 1 June 1995 to 30 June 2018. We investigated whether HT with oestrogen and/or progestogens was associated with changes in use of inhaled anti-asthma therapies in the 12 months following initiation. We used exposure density matching to match exposed subjects with unexposed subjects on age, household income and level of education. An exposed subject was defined as receiving HT. We calculated mean dose of medications and odds ratios of increases in the 12 months following HT initiation. Results We included 139 483 women with asthma, of whom 116 014 (83.2%) were unexposed subjects and 23 469 (16.8%) exposed subjects. Mean±SD age was 53.0±5.2 years. Initiation of HT was not consistently associated with increased mean doses of inhaled corticosteroids (ICS), or long-and short-acting β2-agonists. Women receiving systemic oestrogens had increased odds ratios of large increases (>100 µg) in ICS at 6 months (OR 1.09; 95% CI 1.04–1.13; p<0.001) and 9 months (OR 1.07; 95% CI 1.03–1.12; p<0.001). Progestogens were protective against increases in ICS at 6 and 9 months (OR 0.87; 95% CI 0.82–0.93; p<0.001; and OR 0.86; 95% CI 0.81–0.91; p<0.001). Conclusion Initiation of HT did not change the use of inhaled medications in asthma. However, detrimental effects of oestrogen, as well as beneficial effects of progestogens, cannot be excluded.

U2 - 10.1183/23120541.00611-2021

DO - 10.1183/23120541.00611-2021

M3 - Journal article

C2 - 35350280

AN - SCOPUS:85127650264

VL - 8

JO - ERJ Open Research

JF - ERJ Open Research

SN - 2312-0541

IS - 1

M1 - 00611-2021

ER -