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Breast Cancer Research and Treatment

, Volume 173, Issue 3, pp 511–520 | Cite as

Quantitative comparison of drug efficacy in treating hot flashes in patients with breast cancer

  • Ting Li
  • Juan Yang
  • Yinghua Lv
  • Fang Yin
  • Ling Xu
  • Hongxia Liu
  • Qingshan ZhengEmail author
  • Lujin LiEmail author
Review
  • 292 Downloads

Abstract

Objective

This study aimed to quantitatively evaluate drug efficacy and identify relevant factors that affect the relief of hot flashes in patients with breast cancer.

Methods

A comprehensive literature search was performed using public databases. Randomized clinical studies on drug therapy for the treatment of hot flashes in patients with breast cancer were identified. A time-effect model was established, and crucial pharmacodynamic parameters, such as maximal efficacy (Emax) and onset time (ET50), were used to reflect the differences in efficacy among the drugs.

Results

Eighteen studies involving 5178 subjects were included. It was found that the baseline of hot flashes was an important factor for the Emax value of drugs. After correcting the baseline to the level of eight times per day, the Emax values of progesterone, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs), neuroleptic agents, tibolone, phytoestrogen, other types of drugs, and placebo were 8.3(95%CI 6.8, 9.9),5.1(95%CI 4.4, 5.7), 4.4(95%CI 3.6, 5.3), 4.0(95%CI 3.6, 4.3), 3.4(95%CI 2.4, 4.3), 2.5(95%CI 0.8, 4.2), and 2.7(95%CI 2.1, 3.3), respectively. The ET50 of all the drugs were approximately 2–2.5 weeks, which was obviously longer than that of the placebo (1.2 weeks). When compared with the previously reported efficacy characteristics in natural menopausal women, no significant difference was found between the two populations.

Conclusions

Progesterone showed the highest efficacy, followed by SSRIs/SNRIs, neuroleptic agents, and tibolone, while phytoestrogen and other types of drugs showed no efficacy advantages. There is a significant association between the baseline of hot flashes and drug efficacy, while there was no significant difference between breast cancer patients and natural menopausal women.

Keywords

Hot flashes Breast cancer Medication guidelines Model-based meta-analysis 

Notes

Author Contributions

T.L & J.Y selected studies and extracted the data, analyzed and interpreted the data, YH.L & F.Y wrote the manuscript, and revised the manuscript. HX.L and L.X contributed to data extraction and cleaning. LJ.L and QS.Z participated in conception and design of the work and revised the paper critically for important intellectual content. All authors read and approved the final manuscript. All authors have approved the final article.

Funding

This study was provided by the project of Shanghai Municipal Health Planning Commission (2018YQ48), Science and Technology Innovation Action Plan of Shanghai (17401970900) and National Major Scientific and Technological Special Project for ‘Significant New Drugs Development’ during the Thirteenth Five-year Plan Period (2018ZX09734005-001-002, 2018ZX09734005-006, 2018ZX09711001-009-001, 2018ZX09731016, 2017ZX09304003).

Compliance with ethical standards

Conflict of interest

All the authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors.

Supplementary material

10549_2018_5029_MOESM1_ESM.docx (761 kb)
Supplementary material 1 (DOCX 760 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for Drug Clinical ResearchShanghai University of Traditional Chinese MedicineShanghaiChina

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