Family planners unworried by HRT study's end

The cancellation of a British study into long-term use of hormone replacement therapy should not give New Zealand women more cause for concern, says the Family Planning Association.

Britain's Medical Research Council said yesterday that it stopped the study three months after United States doctors halted a study into HRT after finding the drug could increase the risk of breast cancer, stroke and blood clots.

About 100 New Zealand women were participating in the Women's International Study of Long Duration Oestrogen after Menopause (Wisdom), which was looking at risks and benefits of long-term HRT use.

Family Planning's clinical spokeswoman, Dr Christine Roke, said yesterday that the decision was made after considering the findings of HRT studies, not new research.

"Here in New Zealand we have already considered the research and redrafted our HRT prescribing guidelines," she said.

"Long-term use (more than four years) of combined HRT is not recommended except in limited circumstances," said Dr Roke.

"That is because the recent studies show that the risks of breast cancer, venous thromboembolism, stroke and coronary heart disease outweigh the benefits.

"HRT should not be used for treatment or prevention of cardiovascular disease and it is no longer recommended as first-line treatment for prevention of osteoporosis and fractures."

The Ministry of Health said last month that two New Zealand studies had shown HRT should be used for only limited periods of time.

Dr Bev Lawton, who led the New Zealand section of the British-led HRT study, said it should have continued.

"As New Zealand investigators, we are disappointed that the trial has been stopped early because we feel there are still many questions to be answered in relation to the appropriate use of HRT.

"We felt Wisdom still had the potential to answer this, particularly in some form or other, perhaps in a modified study."

Dr Lawton said women involved would receive a letter explaining why the study was stopped and providing an information line.

Because of the time difference, the women were getting the letters after the information was made public by Britain.

She said women involved in the study had provided fully informed consent before they took part.

"Women were informed of what the risks and benefits of being part of the study would be and they consented."

Philip Hannaford, of the Independent International Committee of advisers that reviewed the results of the US study and other research into HRT, also said he had no safety concerns for participants.

The committee decided the Wisdom study involving 5700 women should be stopped because of several factors including safety and the ethics of continuing it in light of recent information about HRT.

Ray Fitzpatrick, a University of Oxford professor and the committee's chairman, said there was strong evidence that taking HRT for many years raises the risk of some diseases such as breast cancer and decreases the risk of others, including osteoporosis, or brittle-bone disease.

"However, there is no trial evidence that HRT protects women from cardiovascular disease and it may even increase their risk in the short term," Professor Fitzpatrick said.

Pressure to halt the British study mounted after an analysis of four major studies into the effects of HRT supported the US findings.

Overall, the analysis by scientists at the British charity Cancer Research UK showed a woman taking HRT was more likely to contract a life-threatening disease than to be protected against one.

The review showed women who took the treatment for five years had a higher risk of breast cancer, stroke and blood clots in the lung, but were less likely to suffer from bowel cancer or hip fractures.

- NZPA