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Inhaled anti-asthma therapies following hormone therapy in women: a nationwide cohort study

Erik Soeren Halvard Hansen, Kristian Aasbjerg, Amalie Lykkemark Moeller, Amani Meaidi, Elisabeth Juul Gade, Christian Torp-Pedersen, Vibeke Backer
ERJ Open Research 2021; DOI: 10.1183/23120541.00611-2021
Erik Soeren Halvard Hansen
1Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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  • ORCID record for Erik Soeren Halvard Hansen
  • For correspondence: eriksorenhalvardhansen@gmail.com
Kristian Aasbjerg
2Himmerland Eye Clinic, Aars, Denmark
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Amalie Lykkemark Moeller
3Department of Cardiology, North Zealand Hospital, Hilleroed, Denmark
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Amani Meaidi
4Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Elisabeth Juul Gade
5Department of Obstetrics and Gynecology, Roskilde Hospital, Roskilde, Denmark
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Christian Torp-Pedersen
3Department of Cardiology, North Zealand Hospital, Hilleroed, Denmark
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Vibeke Backer
1Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
6Department of Otorhinolaryngology, Rigshospitalet, University of Copenhagen, Denmark
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Abstract

Research question Does menopausal hormone therapy with exogenous estrogens 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 June 1, 1995 to June 30, 2018. We investigated whether hormone therapy with estrogen 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 hormone therapy. We calculated mean dose of medications and odds ratios of increases in the 12 months following hormone therapy 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 age was 53.0 (sd 5.2) years. Initiation of HT was not consistently associated with increased mean doses of inhaled corticosteroids, or long- and short-acting beta2-agonists. Women receiving systemic estrogens had increased odds ratios of large increases (>100 µg) in inhaled corticosteroids at six months (1.09; 95%CI 1.04–1.13; p<0.001) and nine months (1.07; 95%CI 1.03–1.12; p<0.001). Progestogens were protective against increases in inhaled corticosteroids at six and nine months (OR 0.87; 95%CI 0.82–0.93; p<0.001 and 0.86; 95%CI 0.81–0.91; p<0.001).

Conclusion Initiation of hormone therapy did not change the use of inhaled medications in asthma. However, detrimental effects of estrogen, as well as beneficial effects of progestogens, cannot be excluded.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Hansen has nothing to disclose.

Conflict of interest: Dr. Aasbjerg has nothing to disclose.

Conflict of interest: Dr. Moeller has nothing to disclose.

Conflict of interest: Dr. Meaidi has nothing to disclose.

Conflict of interest: Dr. Gade has nothing to disclose.

Conflict of interest: Dr. Torp-Pedersen reports grants from Novo Nordisk, grants from Bayern, outside the submitted work; .

Conflict of interest: Dr. Backer reports grants and personal fees from AstraZeneca, grants and personal fees from GSK, grants and personal fees from TEVA, grants and personal fees from Chiesi, grants and personal fees from Sanofi, grants and personal fees from MSD, grants and personal fees from Novartis, outside the submitted work; .

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received October 28, 2021.
  • Accepted December 4, 2021.
  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Inhaled anti-asthma therapies following hormone therapy in women: a nationwide cohort study
Erik Soeren Halvard Hansen, Kristian Aasbjerg, Amalie Lykkemark Moeller, Amani Meaidi, Elisabeth Juul Gade, Christian Torp-Pedersen, Vibeke Backer
ERJ Open Research Jan 2021, 00611-2021; DOI: 10.1183/23120541.00611-2021

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Inhaled anti-asthma therapies following hormone therapy in women: a nationwide cohort study
Erik Soeren Halvard Hansen, Kristian Aasbjerg, Amalie Lykkemark Moeller, Amani Meaidi, Elisabeth Juul Gade, Christian Torp-Pedersen, Vibeke Backer
ERJ Open Research Jan 2021, 00611-2021; DOI: 10.1183/23120541.00611-2021
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