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Clinical impact of different treatments of osteoporosis
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EMAS2017 / Maturitas 100 (2017) 93–202
that E2-derived COC may be a good option for contraception in perimenopausal age. http://dx.doi.org/10.1016/j.maturitas.2017.03.066 Society Symposium: Erasmus MC Women and cardiometabolic health: Transition through menopause INV62 Estrogen receptor  actions in the female cardiovascular system: A systematic review of animal and human studies Taulant Muka Erasmus MC, Epidemiology, Rotterdam, Netherlands Five medical databases were searched for studies that assessed the role of ER in the female cardiovascular system and the influence of age and menopause on ER functioning. Of 9472 references, 88 studies met our inclusion criteria (71 animal model experimental studies, 15 human model experimental studies and 2 population based studies). ER signaling was shown to possess vasodilator and antiangiogenic properties by regulating the activity of nitric oxide, altering membrane ionic permeability in vascular smooth muscle cells, inhibiting vascular smooth muscle cell migration and proliferation and by regulating adrenergic control of the arteries. Also, a possible protective effect of ER signaling against left ventricular hypertrophy and ischemia/reperfusion injury via genomic and non-genomic pathways was suggested in 27 studies. Moreover, 5 studies reported that the vascular effects of ER may be vessel specific and may differ by age and menopause status. ER seems to possess multiple functions in the female cardiovascular system. Further studies are needed to evaluate whether isoform-selective ER-ligands might contribute to cardiovascular disease prevention. http://dx.doi.org/10.1016/j.maturitas.2017.03.067 Parallel Session: Osteoporosis INV63 Clinical impact of different treatments of osteoporosis Santiago Palacios Instituto Palacios, Madrid, Spain Osteoporosis is a chronic disease which may require treatment for many years and requires not only individual management but often sequential or combination treatments. For many years, we have used antiresorptives as monotherapy, positioning each according to its mechanism of action, vertebral and non-vertebral efficacy and its side-effects. The appearance of the anabolic parathyroid hormone (PTH) agent in its two presentations (teriparatide (PTH1-34) or PTH1-84) has opened new possibilities. Thus, another approach would be to switch or even add an anabolic treatment to ongoing treatment with antiresorptives. Several anabolic and antiresorptive therapies have been combined in an attempt to reach higher bone mass and increased strength compared with monotherapy. The current possibilities are to start with antiresorptive and to keep it for a long time or to switch it to another antiresorptive or an anabolic, or even to combine them at the same time, or to begin with an anabolic and to switch it later by an antiresorptive. When you start with an antiresorptive whether to maintain or modify the treatment depends very much on BMD. If BMD
decreases after 2 years or there is a fracture and secondary causes of loss of bone mass are excluded, a more potent antiresortive agent or sequential or combination therapy with an anabolic agent should be considered. New anabolic agents will appear and the idea of combining antiresorptives with anabolics has more and more evidence and even in specific cases begin with an anabolic agent. http://dx.doi.org/10.1016/j.maturitas.2017.03.068 Society Symposium: British Menopause Society INV64 Premature Ovarian Insufficiency Registry – An update (BMS symposium) Nick Panay Imperial College London, London, United Kingdom Context: Premature ovarian insufficiency (POI) remains poorly understood and under-researched. The POI registry http:// poiregistry.net has been developed using a British Research Council grant to collect national and international data in an effort to avoid fragmented research and improve our understanding of this relatively uncommon but important disease. Objective: Retrospective and prospective registry analysis of women with POI. Methods: Data collected on women diagnosed with POI younger than 40 years have been entered onto an online registry. The data were subsequently extracted and analysed at Imperial College London by patient ages, aetiology, ethnicity, time to diagnosis, symptom profile and bone mineral density (BMD). Results: 45 centres have registered to enter data globally thus far. Many of the centres are in the UK but also include investigators in Australia, Brazil, Canada, Chile, China, Italy, Russia, Spain and South Africa. Retrospective (legacy) data have been entered for 484 women and prospective data for 343 women with POI thus far. Data entry includes demographics, diagnosis, presentation, management and outcomes such as bone mineral density. Collaborative work is being conducted to facilitate biobanking for genetic and biomarker analyses. A key finding from early data analysis is that delay to diagnosis results in lower bone mineral density. These and other data will be presented in detail with focus on diagnosis, presentation and management of POI. Conclusions: The POI registry has proved successful in data collection as shown by the number of centres registered and the number of patients entered thus far. By encouraging more healthcare professionals to engage with data collection, we aim to optimize the quality and quantity of data. http://dx.doi.org/10.1016/j.maturitas.2017.03.069 Parallel Session: Gynecological oncology INV65 Obesity, insulin resistance and endometrial cancer risk Faustino Perez-Lopez University of Zaragoza, Zaragoza, Spain Endometrial cancer (EC) is the most prevalent female genital malignancy in developed regions. It is considered a steroid hormone-dependent cancer, although its prevalence is higher during postmenopausal years (sixth and seventh decades) when ovarian function is minimal and steroid hormone levels are lower
EMAS2017 / Maturitas 100 (2017) 93–202
that E2-derived COC may be a good option for contraception in perimenopausal age. http://dx.doi.org/10.1016/j.maturitas.2017.03.066 Society Symposium: Erasmus MC Women and cardiometabolic health: Transition through menopause INV62 Estrogen receptor  actions in the female cardiovascular system: A systematic review of animal and human studies Taulant Muka Erasmus MC, Epidemiology, Rotterdam, Netherlands Five medical databases were searched for studies that assessed the role of ER in the female cardiovascular system and the influence of age and menopause on ER functioning. Of 9472 references, 88 studies met our inclusion criteria (71 animal model experimental studies, 15 human model experimental studies and 2 population based studies). ER signaling was shown to possess vasodilator and antiangiogenic properties by regulating the activity of nitric oxide, altering membrane ionic permeability in vascular smooth muscle cells, inhibiting vascular smooth muscle cell migration and proliferation and by regulating adrenergic control of the arteries. Also, a possible protective effect of ER signaling against left ventricular hypertrophy and ischemia/reperfusion injury via genomic and non-genomic pathways was suggested in 27 studies. Moreover, 5 studies reported that the vascular effects of ER may be vessel specific and may differ by age and menopause status. ER seems to possess multiple functions in the female cardiovascular system. Further studies are needed to evaluate whether isoform-selective ER-ligands might contribute to cardiovascular disease prevention. http://dx.doi.org/10.1016/j.maturitas.2017.03.067 Parallel Session: Osteoporosis INV63 Clinical impact of different treatments of osteoporosis Santiago Palacios Instituto Palacios, Madrid, Spain Osteoporosis is a chronic disease which may require treatment for many years and requires not only individual management but often sequential or combination treatments. For many years, we have used antiresorptives as monotherapy, positioning each according to its mechanism of action, vertebral and non-vertebral efficacy and its side-effects. The appearance of the anabolic parathyroid hormone (PTH) agent in its two presentations (teriparatide (PTH1-34) or PTH1-84) has opened new possibilities. Thus, another approach would be to switch or even add an anabolic treatment to ongoing treatment with antiresorptives. Several anabolic and antiresorptive therapies have been combined in an attempt to reach higher bone mass and increased strength compared with monotherapy. The current possibilities are to start with antiresorptive and to keep it for a long time or to switch it to another antiresorptive or an anabolic, or even to combine them at the same time, or to begin with an anabolic and to switch it later by an antiresorptive. When you start with an antiresorptive whether to maintain or modify the treatment depends very much on BMD. If BMD
decreases after 2 years or there is a fracture and secondary causes of loss of bone mass are excluded, a more potent antiresortive agent or sequential or combination therapy with an anabolic agent should be considered. New anabolic agents will appear and the idea of combining antiresorptives with anabolics has more and more evidence and even in specific cases begin with an anabolic agent. http://dx.doi.org/10.1016/j.maturitas.2017.03.068 Society Symposium: British Menopause Society INV64 Premature Ovarian Insufficiency Registry – An update (BMS symposium) Nick Panay Imperial College London, London, United Kingdom Context: Premature ovarian insufficiency (POI) remains poorly understood and under-researched. The POI registry http:// poiregistry.net has been developed using a British Research Council grant to collect national and international data in an effort to avoid fragmented research and improve our understanding of this relatively uncommon but important disease. Objective: Retrospective and prospective registry analysis of women with POI. Methods: Data collected on women diagnosed with POI younger than 40 years have been entered onto an online registry. The data were subsequently extracted and analysed at Imperial College London by patient ages, aetiology, ethnicity, time to diagnosis, symptom profile and bone mineral density (BMD). Results: 45 centres have registered to enter data globally thus far. Many of the centres are in the UK but also include investigators in Australia, Brazil, Canada, Chile, China, Italy, Russia, Spain and South Africa. Retrospective (legacy) data have been entered for 484 women and prospective data for 343 women with POI thus far. Data entry includes demographics, diagnosis, presentation, management and outcomes such as bone mineral density. Collaborative work is being conducted to facilitate biobanking for genetic and biomarker analyses. A key finding from early data analysis is that delay to diagnosis results in lower bone mineral density. These and other data will be presented in detail with focus on diagnosis, presentation and management of POI. Conclusions: The POI registry has proved successful in data collection as shown by the number of centres registered and the number of patients entered thus far. By encouraging more healthcare professionals to engage with data collection, we aim to optimize the quality and quantity of data. http://dx.doi.org/10.1016/j.maturitas.2017.03.069 Parallel Session: Gynecological oncology INV65 Obesity, insulin resistance and endometrial cancer risk Faustino Perez-Lopez University of Zaragoza, Zaragoza, Spain Endometrial cancer (EC) is the most prevalent female genital malignancy in developed regions. It is considered a steroid hormone-dependent cancer, although its prevalence is higher during postmenopausal years (sixth and seventh decades) when ovarian function is minimal and steroid hormone levels are lower