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IACP Press Release Archive - 2000
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| 11-27-00 | JAMA Article Causes More Confusion than Clarity |
November 27, 2000 - JAMA Article Causes More Confusion Than Clarity
November 27, 2000
FOR IMMEDIATE RELEASE
Contact: Shelly Capps
International Academy of Compounding Pharmacists
(281) 933-8400
JAMA Article Causes More Confusion Than Clarity
An article, “Menopausal Estrogen and Estrogen-Progestin Replacement Therapy and Breast Cancer Risk,” published in the January 2000 issue of the Journal of the American Medical Association (JAMA), has created considerable confusion for physicians and patients alike due to its failure to delineate between synthetic and natural hormones.
“In our opinion, the JAMA article furthers the argument that natural hormone replacement therapy using bio-identical hormones is a better choice than using synthetic hormones to treat menopause,” said John Preckshot, R.Ph., President and Fellow of The International Academy of Compounding Pharmacists.
“There is a major difference between synthetic and natural hormones,” said Loyd Allen, Ph.D., R.Ph., Fellow of the International Academy of Compounding Pharmacists and Editor-in-Chief of the International Journal of Pharmaceutical Compounding. “Unfortunately no clear distinction is made in the JAMA article. As a result there is a lot of confusion, and physicians and patients may be alarmed unnecessarily,” said Allen.
The article states that estrogen and progestin, prescribed in combination to decrease the risk of endometrial hyperplasia, actually increase the risk of breast cancer. This study suggests what many physicians have been concerned about and why millions of women in the United States have been switched from synthetic hormones to bio-identical hormones, compounded by specialty pharmacists. These bio-identical hormones that the body produces and responds to involve estradiol, estriol, estrone, progesterone and testosterone, which are called natural. Their replacement is termed natural hormone replacement therapy (natural HRT). These bio-identical hormones are in contrast to the administration of commercially available estrogens, progestins and androgens, which are chemically modified products, even though they may actually come from natural animal (nonhuman) sources. As the natural hormones are not patentable substances, there has been little historical interest from the pharmaceutical industry in promoting their use.
“In the study, the primary type of estrogen was a conjugated estrogen (Premarin) and the primary progestin was medroxyprogesterone acetate (Provera). These are “synthetic” hormones and are not the same as those naturally occurring in the body.”
“An article that is as broad-sweeping as this one, implicating all estrogens and progestins, is a disservice to the medical profession. The authors should have distinguished the difference between synthetic and natural hormones,” said John Preckshot, R.Ph., President and Fellow of the International Academy of Compounding Pharmacists.
“Compounding pharmacists, with a physician’s prescription, create medications for natural hormone replacement therapy using bio-identical hormones. Bio-identical hormones should not be confused with these synthetic hormones. The distinction is critical, and it is irresponsible reporting to publish a study that does not make that distinction clear. JAMA should have provided clarification before causing so much disorder,” said Preckshot.
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