Does letrozole treatment have favorable effects on the lipid profile? A systematic review and meta-analysis of randomized clinical trials

• Published in: Steroids Vol. 172; p. 108875
• Main Authors: Cai, Tao, Al-Jubairi, Nashmi Naife, Santos, Heitor O., de Souza, Ivan G.O., Chen, Youdong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2021
• Subjects: Aromatase Inhibitors - pharmacology; Cholesterol - metabolism; Cholesterol, LDL - metabolism; HDL; Humans; LDL; Letrozole; Letrozole - pharmacology; Lipid profile; Lipids - analysis; Randomized Controlled Trials as Topic; Triglycerides; Lipid profile; HDL; Triglycerides; LDL; Letrozole
• ISSN: 0039-128X; 1878-5867
• DOI: 10.1016/j.steroids.2021.108875

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•Treatment with letrozole significantly decreased both HDL-C and LDL-C levels.•No significant effect was observed for TG and TC levels.•The statistical significant change does not represent a clinical magnitude.
As an aromatase inhibitor, letrozole reduces estrogen levels, affecting lipid indices because of the positive role of estrogens in modulating lipoproteins and lipids. Thus, our aim was to meta-analyze data regarding letrozole administration and its effects on the traditional lipid profile. A systematic review and meta-analysis of randomized clinical trials (RCTs) were performed based on the PRISMA guidelines. Web of Science, Scopus, PubMed/Medline, and EMBASE databases were searched until February 11, 2021. From 341 potentially relevant publications, 8 RCTs were selected. All studies used 2.5 mg/d of letrozole. Total cholesterol changed significantly by −6.28 mg/dL (95% CI: −8.73, −3.84, P < 0.001) and HDL-C by −4.40 mg/dL (95% CI: −5.30 to −3.50, p < 0.001) in letrozole group when compared to the control group. Taking into account this comparison between groups, in contrast, LDL-C (WMD: −2.50 mg/dL, 95% CI: −9.94, 4.93, p = 0.510) and triglycerides (WMD: −0.89 mg/dL, 95% CI: −6.87 to 5.07, p = 0.768) did not alter. In conclusion, letrozole administration decreased the concentrations of HDL-C and tocal cholesterol, but not of triglycerides and LDL-C.