The study will examine the effects of estrogen and progesterone on the development of atherosclerosis in menopausal women when hormone treatment is initiated within 3 years of the menopausal transition.
The KEEPS is designed to explore the hypothesis that early initiation of hormone therapy, in women who are at the inception of their menopause, will decrease the rate of accumulation of atherosclerotic plaque, indicating a likely delay in the onset of clinical cardiovascular disease. The study is designed as a multicenter, 4 year randomized clinical trial. It will evaluate the effectiveness of of 0.45 mg/day of oral conjugated equine estrogens or 50 mcg/day of transdermal estradiol via skin patch changed weekly (each in combination with cyclic oral, micronized progesterone, 200 mg daily for 12 days per month), versus placebo in preventing progression of carotid intimal medial thickness by sonogram and the accrual of coronary calcium in women aged 42-58 who are within 36 months of their final menstrual period at initiation of treatment. A number of secondary endpoints including biochemical and genetic risk factors for cardiovascular and thrombotic disease, and effects on cognition will also be studied. The study will enroll a total of 720 women in 2005-6, with an anticipated completion of the trial in 2010.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
728
Pill, 1 pill taken daily each month for the study duration
Patch; 1 patch is applied to the skin weekly. Patch site is rotated on a weekly basis.
capsule, 1 capsule taken daily for the first 12 days of each month for the study duration
Kronos Longevity Research Institute
Phoenix, Arizona, United States
University of California, San Francisco
San Francisco, California, United States
Yale University Medical Center
New Haven, Connecticut, United States
Rate of change of carotid intimal medial thickness by ultrasound
Time frame: Measured at screening, 12, 24, 36, and 48 months
Change in coronary calcium score by X-ray tomography
Time frame: Meassured at screening and at 48 months
Plasma lipid profiles
Time frame: Samples taken at screening , 12, 36, and 48 months
Blood clotting factors
Time frame: Samples taken at screening, 12, 36 and 48 months
Serum inflammatory factors
Time frame: Samples taken at screening, 12, 36 and 48 months
Hormone levels
Time frame: Samples taken at screening, 12, 36 and 48 months
Cognitive and Affective scores on standard psychometric tests
Time frame: Testing is conducted at Baseline, 18, 36 and 48 months
Quality of life
Time frame: Measured at Baseline, 18, 36 and 48 months
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CEE 0.45mg 1 PO QD Progesterone 200 mg 1 PO HS first 12 days of the month estradiol patch use 1 per week
CEE 0.45 mg 1 PO QD or placebo equivalent Prometrium 200 mg 1 PO qHS for first 12 dasy of each month or placebo equivalent transdermal patch 0.05 mg use 1 patch per week or placebo equivalent
Brigham and Women's Hospital
Boston, Massachusetts, United States
Mayo Clinic
Rochester, Minnesota, United States
Columbia Presbyterian Hospital
New York, New York, United States
Albert Einstein College of Medicine
The Bronx, New York, United States
University of Utah
Salt Lake City, Utah, United States
University of Washington/VA Puget Sound, HCS
Seattle/Tacoma, Washington, United States