Therapy
Meta-analysis of RCTs finds tamoxifen modestly lowers Lp(a) alongside ApoB in women treated for breast cancer (Exp Gerontol 2024)
Original title: The effect of tamoxifen as an adjuvant therapy for breast cancer on apolipoproteins and lipoprotein(a) concentrations in women: A meta-analysis of randomized controlled trials
This meta-analysis of randomised controlled trials published through September 2023 examined tamoxifen's effect on apolipoproteins and Lp(a) in women, given previously controversial evidence. Pooled results using a random-effects model showed tamoxifen significantly raised ApoA-I (weighted mean difference 16.24 mg/dL, 95% CI 5.35-27.12, P = 0.003), lowered ApoB (weighted mean difference -9.37 mg/dL, 95% CI -15.16 to -3.59, P = 0.001), and lowered Lp(a) (weighted mean difference -3.24 mg/dL, 95% CI -5.66 to -0.83, P < 0.001). A single study specifically in breast cancer patients showed an even larger ApoB decrease (weighted mean difference -12.86 mg/dL) and ApoA-I rise (weighted mean difference 51.97 mg/dL). The findings clarify that tamoxifen, widely used as adjuvant breast cancer therapy, produces a modest but statistically significant favourable shift in Lp(a) and apolipoprotein profile alongside its oncologic role.
Original abstract
Background And Aim: Tamoxifen has been used in the management of breast cancer. The available evidence on the effect of tamoxifen on lipoprotein(a) and apolipoproteins is controversial. Hence, this meta-analysis of randomized controlled trials (RCTs) was conducted to increase the quality of evidence on the effect of tamoxifen on lipoprotein(a) and apolipoproteins.
Methods: Eligible RCTs published up to September 2023 were carefully selected following a comprehensive search. Thereafter, a meta-analysis was conducted using a random-effects model and the results were presented as the weighted mean difference (WMD) with a 95 % confidence interval (CI).
Results: The results from the random-effects model indicated a rise in ApoA-I (WMD: 16.24 mg/dL, 95 % CI: 5.35, 27.12, P = 0.003), and a decrease in ApoB (WMD: -9.37 mg/dL, 95 % CI: -15.16, -3.59, P = 0.001) and lipoprotein(a) (WMD: -3.24 mg/dL, 95 % CI: -5.66, -0.83, P < 0.001) concentrations following tamoxifen administration in women. Furthermore, a more pronounced decrease in ApoB (WMD: -12.86 mg/dL, 95 % CI: -19.78, -5.93, P < 0.001) and elevation in ApoA-1 levels (WMD: 51.97 mg/dL, 95 % CI: 45.89, 58.05, P < 0.001) were identified in a single study on patients with breast cancer.
Conclusion: The current meta-analysis demonstrated an increase of ApoA-I and a decrease of ApoB and lipoprotein(a) levels after treatment with tamoxifen in women.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.