Re: GYN: Menostar
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Wed Sep 29 17:08:58 2004
Thanks for the input. Joanne, would love to see anything you find.
Garry
At Wed, 29 Sep 2004, Charlie Chambers wrote:
>
>--Apple-Mail-1-64545382
>Content-Transfer-Encoding: quoted-printable
>Content-Type: text/plain;
> charset=ISO-8859-1;
> delsp=yes;
> format=flowed
>
>Two years doesn't seem long enough to feel confident about hyperplasia
>incidents. Plus, no meaningful fracture data. Would be a lot more
>helpful if these companies that are putting forth new meds for osteo to
>get some fracture data instead of quick BMD data.
>
>On Sep 29, 2004, at 11:24 AM, RModugno@aol.com wrote:
>
>> In a message dated 9/29/04 12:14:35 AM Eastern Daylight Time,
>> zbnewton@bellsouth.net writes:
>> The limiting issue is the outlier who develops an endometrial
>> malignancy
>> while under such a regimen that has not been standardized The
>> liability
>> issue will devastate the prescriber, regardless of benefit/risk
>> arguments.
>>
>> If the uterus is there with estrogen therapy, progesterone/progestin
>> additive on a standardized basis is obligatory. By today's standards,
>> p-therapy every 4 or 6 months for the individual who does develop
>> endometrial carcinoma will come back to bite you.
>>
>> Zach Newton
>> Z. B. Newton, III, M.D.
>> Atlanta/ Gyn
>> Zach, this comes from Berlex:
>>
>>
>> "Menostar is a fundamentally new approach to post-menopausal
>> osteoporosis prevention. In a two-year clinical study, Menostar, with
>> a very low dose of estrogen, did not increase the risk of endometrial
>> hyperplasia among women with a uterus. Therefore, this patch does not
>> require a daily or monthly concomitant progestin," said Marie Foegh,
>> M.D., Vice President, Medical Affairs for Berlex Laboratories. "Until
>> now, we in the medical community never knew such small amounts of
>> estrogen could help maintain bone health. With Menostar, we can return
>> a woman's estrogen to the lowest level proven to prevent bone loss."
>>
>> I would suggest, therefore, that a 4 to 6 month progesterone
>> "challenge' is acceptable therapy.
>>
>> Robert Modugno Md MBA FACOG
>>
>> Marietta, GA
>>
>> http://www.novaobgyn.yourmd.com
>>
>>
>>
>************************************************************************
>****
>************************************************************************
>
>--
>Charlie Chambers
>Hood River, OR USA
>cchamber@alumni.rice.edu
>
>"...not because I regard fishing as being so terribly
>important but because I suspect that so many of the other
>concerns of men are equally unimportant-and not nearly
>so much fun."
> John Voelker
>************************************************************************
>*****
>************************************************************************
>
>--Apple-Mail-1-64545382
>Content-Transfer-Encoding: quoted-printable
>Content-Type: text/enriched;
> charset=ISO-8859-1
>
>Two years doesn't seem long enough to feel confident about hyperplasia
>incidents. Plus, no meaningful fracture data. Would be a lot more
>helpful if these companies that are putting forth new meds for osteo
>to get some fracture data instead of quick BMD data.
>
>On Sep 29, 2004, at 11:24 AM, RModugno@aol.com wrote:
>
><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>In a message
>dated 9/29/04 12:14:35 AM Eastern Daylight Time,
>zbnewton@bellsouth.net writes:</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>The limiting
>issue is the outlier who develops an endometrial malignancy</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>while under
>such a regimen that has not been standardized The liability</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>issue will
>devastate the prescriber, regardless of benefit/risk arguments.</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>If the uterus
>is there with estrogen therapy, progesterone/progestin</x-tad-smaller></smaller></fontfamily></excerpt><e cerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>additive on a
>standardized basis is obligatory. By today's standards,</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>p-therapy
>every 4 or 6 months for the individual who does develop</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>endometrial
>carcinoma will come back to bite you.</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>Zach Newton</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>Z. B. Newton,
>III, M.D.</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>Atlanta/ Gyn</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>Zach, this
>comes from Berlex:</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
>><fontfamily><param>Arial</param><smaller><x-tad-smaller> </x-tad-smalle ></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>"Menostar is a
>fundamentally new approach to post-menopausal osteoporosis prevention.
>In a two-year clinical study, Menostar, with a very low dose of
>estrogen, did not increase the risk of endometrial hyperplasia among
>women with a uterus. Therefore, this patch does not require a daily or
>monthly concomitant progestin," said Marie Foegh, M.D., Vice
>President, Medical Affairs for Berlex Laboratories. "Until now, we in
>the medical community never knew such small amounts of estrogen could
>help maintain bone health. With Menostar, we can return a woman's
>estrogen to the lowest level proven to prevent bone loss."</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>I would
>suggest, therefore, that a 4 to 6 month progesterone "challenge' is
>acceptable therapy.</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>Robert Modugno
>Md MBA FACOG</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
><fontfamily><param>Arial</param><smaller><x-tad-smaller>Marietta, GA</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
>><fontfamily><param>Arial</param><smaller><x-tad-smaller>http://www.novaobgyn.you md.com</x-tad-smaller></smaller></fontfamily></excerpt><excerpt>
>
>><fontfamily><param>Arial</param><smaller><x-tad-smaller> </x-tad-smalle ></smaller></fontfamily></excerpt><excerpt>
>
>></excerpt>*************************************************************** ************
>
></excerpt>*************************************************************** ************
>Charlie Chambers
>
>Hood River, OR USA
>
>cchamber@alumni.rice.edu
>
>"...not because I regard fishing as being so terribly
>
>important but because I suspect that so many of the other
>
>concerns of men are equally unimportant-and not nearly
>
>so much fun."
>
> John Voelker
>
>>************************************************************************* ***
>
>************************************************************************* ***
>
>--Apple-Mail-1-64545382--
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
