Therapy
Anti-oestrogen therapy lowers Lp(a) by 5.92% in postmenopausal women, a meta-analysis of 10 double-blind placebo-controlled trials (Endocrine 2023)
Original title: Impact of anti-oestrogen therapy on lipoprotein(a) in postmenopausal women: a systematic review and meta-analysis of double-blind placebo-controlled clinical studies
This systematic review and meta-analysis pooled data from 10 randomised, double-blind, placebo-controlled trials (24 treatment arms, 2,049 postmenopausal women: 1,128 in active treatment and 921 in control arms) examining the effect of anti-oestrogen therapy on Lp(a), a recognised prothrombotic factor. Anti-oestrogen therapy significantly reduced Lp(a) (mean difference -5.92%, 95% CI -9.05% to -2.8%). The findings add anti-oestrogen therapy to the list of agents that modestly lower Lp(a) in postmenopausal women, though the authors note that the molecular pathways underlying Lp(a) synthesis and metabolism remain incompletely understood.
Original abstract
Purpose: The potential mechanisms of endocrine therapy for thrombosis remain currently unclear, and more studies are warranted for further investigation and elucidation. However, high plasma concentration of lipoprotein(a) (Lp(a)) is a recognized prothrombotic factor. The aim of our study was to systematically evaluate the effect of different anti-oestrogen therapy on plasma Lp(a) level in postmenopausal women.
Methods: A systematic literature search was conducted in multiple electronic databases to identify the randomized, double-blind, placebo-controlled clinical studies on this topic. Effect size for changes in Lp(a) was expressed as mean difference (MD) and 95% confidence intervals (CI).
Results: Data were pooled from 10 clinical trials comprising 24 treatment arms, which included 2049 women (1128 women in the active-treated arms and 921 women in the control arms). Meta-analysis of data suggested that anti-oestrogen therapy in women significantly reduced Lp(a) [MD = -5.92% (95%CI: -9.05%,-2.8%)].
Conclusions: This observation is of both clinical and pathophysiological relevance, also in view that the identification of molecular determinants and cellular pathways implicated in Lp(a) synthesis and metabolism is still of concern as a critical issue in lipidology and CV prevention.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.