Tissue-selective Estrogen Complex

Aka: Tissue-selective Estrogen Complex, TSEC, Bazedoxifene, Duavee

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II. Definitions

  1. Tissue-selective Estrogen Complex (TSEC)
    1. Combination of Estrogen with a Selective Estrogen Receptor Modulator (SERM)

III. Indications

  1. Tissue-selective Estrogen Complex (TSEC)
    1. Estrogen Replacement Therapy in patients with an intact Uterus

IV. Background

  1. Duavee is the first Tissue-selective Estrogen Complex or TSEC (released in 2014)
  2. Duavee is a combination of Conjugated Estrogen with Bazedoxifene (SERM)
    1. Alternative to combination Estrogen with Progesterone

V. Efficacy

  1. Duavee (Conjugated Estrogen AND Bazedoxifene)
    1. Unclear role outside of cases of Estrogen Replacement with intact Uterus, in which Progesterone is contraindicated
    2. SERMs add potential for increased adverse effects with no added benefit when used in combination with Estrogen
      1. No additional bone protection in Osteoporosis
    3. Effective in decreasing vasomotor symptoms
      1. Significantly reduces vasomotor symptoms without affecting Breast tissue, endometrium or VTE or Cardiac Risk
      2. Lello (2017) Int J Endocrinol 2017:5064725 +PMID: 29358948 [PubMed]

VI. Medications

  1. Duavee (Conjugated Estrogen 0.45 mg with Bazedoxifene 20 mg)

VII. References

  1. (2014) Presc Lett 21(3)

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