Skip to content

European Active Surveillance Study of Women Taking Hormone Replacement Therapy (HRT)

European Active Surveillance Study of Women Taking HRT

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT00214903
Enrollment
30597
Registered
2005-09-22
Start date
2004-11-30
Completion date
2011-11-30
Last updated
2014-12-01

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Menopausal Symptoms

Keywords

Postmenopause, HRT

Brief summary

The objective of the active surveillance study is to compare incidence rates of serious adverse events in users of all types of newly prescribed oral continuous combined HRT products. The primary focus is the assessment of pertinent cardiovascular outcomes (such as venous and arterial thromboembolism) in new HRT users for up to 8.5 years.

Detailed description

The safety of a novel drug product containing a new chemical entity should be assessed in an extensive post marketing safety surveillance program. It is also prudent to assess both, the safety outcomes that relate specifically to the targeted population, as well as those that could potentially be related to the special pharmacological characteristics of the novel drug product. Differentiating between the inherent background population risk and a potential incremental risk due to treatment is often challenging. Active safety surveillance using valid epidemiological study designs has been proven to be a pertinent and reliable method to approach this endeavour. The primary objective of the study, the European Active Surveillance Study of Women taking HRT (EURAS-HRT), is to compare incidence rates of serious adverse events in users of all types of newly prescribed oral continuous combined HRT products. This active surveillance study will assess pertinent cardiovascular outcomes in new HRT users over a study period of up to 8.5 years. Also, all other serious adverse events will be reported. The new drug product under surveillance in the EURAS - HRT study contains the novel synthetic progestagen drospirenone (DRSP) combined with estradiol. As estrogen/progestagen combinations increase the risk for thromboembolism, all new drug products that contain a novel estrogen or progestagen should be investigated for their influence on venous and arterial thromboembolic events rates. A large, prospective, controlled cohort study of OC users (EURAS OC study), which compared DRSP-containing OC users with other OC users, demonstrated that DRSP is not associated with an increased incidence for any of the above-mentioned adverse events in OC users. However, because OC users are two to three decades younger than the typical HRT user the results of the OC study can only partially be extrapolated to older age groups. The participating women will complete a baseline survey using a self-administered questionnaire to describe the baseline risk. After 6 months, 12 months, and then on an annual basis, they will fill out a questionnaire in which they record complaints and events during the use of the prescribed HRTs. All adverse outcomes (including cancer) occurring during the observational period will be evaluated additionally. Reported serious adverse events will be validated and analyzed. As study participants may switch from oral continuous combined products to other oral or non-oral HRT products the outcomes for these preparation are recorded too. However, these results represent not the scientific focus of the study. Based on experience obtained in previous HRT studies, complex sources of bias and confounding are expected. Multivariate methods will therefore be used to adjust for confounding.

Interventions

None listed

Sponsors

Bayer
CollaboratorINDUSTRY
Center for Epidemiology and Health Research, Germany
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
FEMALE
Age
40 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* All women aged 40 or more years who started use of a new oral HRT at the time of inclusion in the study

Exclusion criteria

* Women who do not consent to participate in the study

Design outcomes

Primary

MeasureTime frameDescription
Venous Thromboembolism (e.g., Deep Venous Thrombosis and Pulmonary Embolism)within 8.5 yearsVenous thromboembolism (VTE) linked to the use of continuous combined HRT containing both drospirenone (DRSP) and estradiol (E2) or to other oral continuous combined HRT preparations.
Arterial Thromboembolism (e.g., Acute Myocardial Infarction and Stroke)within 8.5 yearsArterial thromboembolism (ATE) linked to the use of continuous combined HRT containing both drospirenone (DRSP) and estradiol (E2) or to other oral continuous combined HRT preparations.

Countries

Germany

Participant flow

Recruitment details

Overall, 31,321 patients were recruited for the EURAS HRT study. 724 patients were excluded due to protocol violations (e.g., patient agreed to participate but never started to use the new HRT preparation or continued to use a previously prescribed preparation).

Participants by arm

ArmCount
DRSP/E2
Users of oral continuous combined preparations containing 2mg DRSP and 1mg estradiol
10,043
ooccHRT
Users of other oral continuous combined HRT preparations containing other progestogens
13,384
ooHRT
Users of oral but not continuous combined HRT preparations
4,113
Non-oral HRT
Users of non-oral HRT preparations
3,057
Total30,597

Baseline characteristics

CharacteristicDRSP/E2ooccHRTooHRTNon-oral HRTTotal
Age, Continuous52.4 years
STANDARD_DEVIATION 6.4
55.1 years
STANDARD_DEVIATION 6.9
52.9 years
STANDARD_DEVIATION 8.3
56.2 years
STANDARD_DEVIATION 7.7
54.0 years
STANDARD_DEVIATION 7.3
Region of Enrollment
Europe
10043 participants13384 participants4113 participants3057 participants30597 participants
Sex: Female, Male
Female
10043 Participants13384 Participants4113 Participants3057 Participants30597 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
0 / 10,0430 / 13,3840 / 4,1130 / 3,057
serious
Total, serious adverse events
707 / 10,0431,998 / 13,384576 / 4,113508 / 3,057

Outcome results

Primary

Arterial Thromboembolism (e.g., Acute Myocardial Infarction and Stroke)

Arterial thromboembolism (ATE) linked to the use of continuous combined HRT containing both drospirenone (DRSP) and estradiol (E2) or to other oral continuous combined HRT preparations.

Time frame: within 8.5 years

Population: The number of participants refers to the ITT study population. During the course of the study, women could for example stop hormonal treatment at any point of time. Therefore, the woman-years of exposure for each group are provided in addition.

ArmMeasureValue (NUMBER)
DRSP/E2Arterial Thromboembolism (e.g., Acute Myocardial Infarction and Stroke)15 participants
ooccHRTArterial Thromboembolism (e.g., Acute Myocardial Infarction and Stroke)95 participants
ooHRTArterial Thromboembolism (e.g., Acute Myocardial Infarction and Stroke)33 participants
Non-oral HRTArterial Thromboembolism (e.g., Acute Myocardial Infarction and Stroke)23 participants
Comparison: Tested null hypotheses: the ATE hazard ratio for DRSP/E2 vs. ooccHRT is higher or equal to 2.95% CI: [0.3, 0.8]
Primary

Venous Thromboembolism (e.g., Deep Venous Thrombosis and Pulmonary Embolism)

Venous thromboembolism (VTE) linked to the use of continuous combined HRT containing both drospirenone (DRSP) and estradiol (E2) or to other oral continuous combined HRT preparations.

Time frame: within 8.5 years

Population: The number of participants refers to the ITT study population. During the course of the study, women could for example stop hormonal treatment at any point of time. Therefore, the woman-years of exposure for each group are provided in addition.

ArmMeasureValue (NUMBER)
DRSP/E2Venous Thromboembolism (e.g., Deep Venous Thrombosis and Pulmonary Embolism)24 participants
ooccHRTVenous Thromboembolism (e.g., Deep Venous Thrombosis and Pulmonary Embolism)74 participants
ooHRTVenous Thromboembolism (e.g., Deep Venous Thrombosis and Pulmonary Embolism)21 participants
Non-oral HRTVenous Thromboembolism (e.g., Deep Venous Thrombosis and Pulmonary Embolism)12 participants
Comparison: Tested null hypotheses: the VTE hazard ratio for DRSP/E2 vs. ooccHRT is higher or equal to 2.95% CI: [0.5, 1.3]

Source: ClinicalTrials.gov · Data processed: Mar 1, 2026