Published June 3, 2014
Noted epidemiologist Jean Wactawski-Wende, PhD, who has played a leading role in groundbreaking national women’s health research, highlighted results of the Women’s Health Initiative (WHI) hormone therapy clinical trials during her Stockton Kimball lecture May 29.
Wactawski-Wende shared key aspects of the landmark initiative, which has generated crucial information about disease and death in postmenopausal women, including minorities.
More than 162,000 women, including nearly 4,000 from the Buffalo area, have enrolled in various study components. The local study has involved many University at Buffalo graduate student researchers and more than 50 investigators and staff.
For more than two decades, Wactawski-Wende has led UB’s participation in this national initiative. She now directs its Northeast Regional Center, which involves nine institutions, and she chairs the Steering Committee for the national study.
She has been a faculty member in the Department of Obstetrics and Gynecology for 25 years, and she is currently a volunteer professor.
She also is UB’s vice provost for strategic initiatives and research advancement as well as professor and associate chair of epidemiology and environmental health in the School of Public Health and Health Professions.
Her lecture focused on results of the hormone therapy clinical trials involving more than 27,000 women. This included one trial that evaluated estrogen-plus-progestin treatment (E+P) and a second evaluating estrogen alone.
Surprising findings showed E+P significantly increased risk for breast cancer, stroke, heart disease and pulmonary embolism in the treatment group and — as a result — the trial was discontinued in 2002.
Ultimately, findings from this and related trials led to recommendations to not use hormonal therapy long-term or for coronary heart disease prevention. The results also led to Food and Drug Administration warnings on all postmenopausal estrogen and hormone products.
According to a new report analyzing the E+P trial’s long-term economic impact, the study has led to dramatic changes in women’s medical treatment.
Researchers estimate that the resulting marked decrease in the use of hormonal therapy has saved thousands of lives and produced a net return of $37.1 billion — or $140 for every dollar spent by the National Institutes of Health on the study. In addition, an estimated 200,000-plus health outcomes were averted, including fewer breast cancers.
As the remaining women in the study grow older, the initiative is shifting emphasis to study aspects of healthy aging, Wactawski-Wende said.
She also presented information about a newer focus of her research team on periodontal disease, the oral microbiome and systemic diseases, including cancer.
The “OsteoPerio” study involving 1,300 women from Western New York, for example, has already explored links between periodontal disease and osteoporosis.
Looking forward to new collaborations, Wactawski-Wende will lead a nearly $4 million study that will build on data from the OsteoPerio study. The goal is to explore the make-up of the subgingival oral microbiome and how it changes over time. The study also aims to determine factors, including personal characteristics, that contribute to periodontal disease and systemic health.
The research might lead to other interventional opportunities and “new therapeutic targets to think about,” said Wactawski-Wende.
“There is much more to be learned,” she added. “I believe this is a new area of research that can increase our scientific understanding of how bacteria living in and on us affect our health — this is a phenomenal new opportunity.”
As the winner of the School of Medicine and Biomedical Sciences’ 2013 Stockton Kimball Award, Wactawski-Wende was recognized for her outstanding research contributions and significant service to UB.
Following tradition, she shared her research findings with her colleagues the year after receiving her award.
The award and lecture memorialize Stockton Kimball, MD ’29, dean of the UB medical school from 1946 to 1958, and they commemorate his contributions to physician training for more than 25 years.