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May 13, 1998

Of Designer Drugs, Magic Bullets, and Gold Standards

Author Affiliations

From the National Heart, Lung, and Blood Institute, Bethesda, Md.

JAMA. 1998;279(18):1483-1485. doi:10.1001/jama.279.18.1483

Evaluating the risks and benefits of estrogen and related drugs after menopause is complex given their diverse properties. Major considerations include the effects of such agents on cardiovascular and bone disease; breast and endometrial cancer; the plasma lipoproteins and the blood coagulation system; and hot flashes, vaginal bleeding, breast tenderness, and urogenital function. Some effects may be beneficial, others may be adverse. From these multifaceted and often disparate properties attempts are made to construct a balance sheet to better help select from the available agents those that provide the most benefit and the least harm.1,2 This approach is important in considering the appropriateness of the therapy either for the individual patient or from the standpoint of public health.

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