The long-term tolerability and efficacy of OESCLIM: results of a 1-year study

Transdermal hormone therapy: gels and patches

Hormone therapy (HT) in the climacteric has a number of beneficial effects including mitigation of climacteric symptoms and prevention of osteoporosis. Administration of HT via the transdermal route avoids hepatic first-pass metabolism and therefore the high plasma levels of estrogen metabolites that are associated with oral administration. Patch formulations have traditionally been the most common form of transdermal HT. However, as patches may be associated with local skin reactions, gel formulations have been developed in an attempt to improve acceptability and compliance with transdermal HT. Patch and gel formulations are equally as effective in treating climacteric symptoms and improving bone mineral density, and the effects are comparable to those achieved by oral HT.

OESCLIM: summary of tolerability and safety

INTRODUCTION

The benefits of transdermally administered estradiol have been well documented in a number of studies. OESCLIM is a new transdermal matrix system which has been developed with the objective of providing improved local skin tolerability and adhesion, whilst minimising hyperestrogenic effects.

METHODS

Data relating to OESCLIM's tolerability and safety profile were reviewed.

RESULTS

In a randomised, controlled comparative clinical trial, OESCLIM resulted in less than half as many application site reactions than Estraderm TTS (4.3 compared to 9.5%). In addition, the duration of reactions was significantly lower in the OESCLIM group. OESCLIM has been well tolerated in all clinical trials and was reported to have comparable estrogen-specific tolerability as Estraderm TTS. Low dose OESCLIM (25 microg/day) is associated with a reduction in hyperestrogenic side effects compared to higher doses. In a study of long term OESCLIM therapy, 79% of patients wished to continue therapy after 1 year, and in a follow up study 79.8% wished to continue at the end of the 3 year study.

CONCLUSION

OESCLIM offers doctors an alternative to current transdermal therapy that is safe and effective and suitable for the majority of women. It has a better local tolerability and safety profile than Estraderm TTS and its safety has been proven in both short and long-term trials. The extensive range of OESCLIM doses available means doctors have a large flexibility and choice when it comes to deciding on an appropriate regimen including the option to initiate therapy at a low dose.

OESCLIM: an advanced delivery system for HRT

AIMS

Transdermal estradiol offers a number of advantages over traditional oral routes of hormone replacement therapy (HRT) because it is not subject to the hepatic first-pass effect. However, transdermal systems need to balance adhesion, tolerability, and flux if they are to be effective. OESCLIM is a transdermal 17-beta estradiol HRT system designed to address the problems of conventional transdermal patches and offer optimal adhesion and tolerability in an effective HRT system. This paper reviews some of the data on OESCLIM with reference to its delivery system.

RESULTS

The innovative technology used in OESCLIM results in a smooth pharmacokinetic profile throughout the 3-4 day application period. In recent pharmacokinetic studies, OESCLIM 50 provided a more consistent release of hormone than Estraderm TTS 50 and higher mean estradiol levels than Systen and Vivelle. This smooth pharmacokinetic profile is also maintained whether OESCLIM is attached to different body sites. The local skin tolerability of OESCLIM is good. One study reported that OESCLIM 50 caused less than half the number of skin reactions as Estraderm TTS 50 (4.2% compared to 9.5%). OESCLIM has also been shown to have fewer detachments than Estraderm TTS (6% compared to 11%). Both differences were statistically significant (P < 0.001). A study has shown OESCLIM to be as effective as Estraderm TTS at reducing vasomotor symptoms even in highly symptomatic women.

CONCLUSION

OESCLIM is a very good first-line choice for estrogen replacement therapy (ERT) or HRT providing effective therapy with optimum adhesion, flux and tolerability profiles.

OESCLIM: pre-clinical and clinical profile

INTRODUCTION

The majority of women will suffer some form of vasomotor symptoms at the menopause. Hormone replacement therapy (HRT) has been shown to reduce the incidence of these symptoms although compliance with HRT is still poor. OESCLIM is a transdermal estrogen-replacement therapy for the treatment of estrogen deficiency.

METHODS

In this paper, the main pre-clinical and clinical data relating to OESCLIM are reviewed.

RESULTS

OESCLIM has a stable pharmacokinetic profile over the treatment period of 3-4 days and has been shown to have advanced pharmacokinetics when compared to other leading transdermal systems. It has been shown to reduce vasomotor symptoms by 94% in post-menopausal women, with near maximal reduction in symptoms after 4 weeks of treatment. In highly symptomatic women, low dose (25 microg/day) OESCLIM therapy resulted in a statistically significant reduction in symptoms compared to placebo from week 3. OESCLIM also has good local skin tolerability, and is significantly better tolerated than Estraderm TTS 50. It is also well accepted among patients. In long-term studies, 79.8% of patients wished to continue OESCLIM therapy at the end of a 3-year study.

CONCLUSION

OESCLIM is an innovative first-line transdermal estrogen-replacement therapy with good efficacy and tolerability. The ability to initiate treatment at a low dose (25 microg/day) may have advantages for the patient starting therapy by reducing symptoms of hyperestrogenism whilst allowing for dose titration upwards if necessary.