The Effects of Tamoxifen on Plasma Lipoprotein(a) Concentrations: Systematic Review and Meta-Analysis


Amirhossein Sahebkar | Maria-Corina Serban | Peter Penson | Camelia Gurban | Sorin Ursoniu | Peter P. Toth | Steven R. Jones | Giuseppe Lippi | Kazuhiko Kotani | Karam Kostner | Manfredi Rizzo | Jacek Rysz | Maciej Banach,corresponding author | and for the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group


Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of breast cancer. Tamoxifen therapy is associated with lower circulating low-density lipoprotein cholesterol and increased triglycerides, but its effects on other lipids are less well studied.

We aimed to investigate the effect of tamoxifen on circulating concentrations of lipoprotein(a) [Lp(a)] through a meta-analysis of available randomized controlled trials (RCTs) and observational studies.

This study was registered in the PROSPERO data base (CRD42016036890). Scopus, MEDLINE and EMBASE were searched from inception until 22 March 2016 to identify studies investigating the effect of tamoxifen on Lp(a) values in humans. Meta-analysis was performed using an inverse variance-weighted, random-effects model with standardized mean difference (SMD) as the effect size estimate.

Meta-analysis of five studies with 215 participants suggested a statistically significant reduction of Lp(a) levels following tamoxifen treatment (SMD −0.41, 95% confidence interval −0.68 to −0.14, p = 0.003). This effect was robust in the sensitivity analysis.

Meta-analysis suggested a statistically significant reduction of Lp(a) levels following tamoxifen treatment. Further well-designed trials are required to validate these results.

Full content publication available for download

Author contributions

Maciej Banach, Maria-Corina Serban, Camelia Gurban, Sorin Ursoniu and Amirhossein Sahebkar conceived and designed the work, and contributed to the drafting of the manuscript. Maria-Corina Serban, Peter Penson and Sorin Ursoniu performed the searches and extracted data. Amirhossein Sahebkar performed the statistical analysis. Peter Penson, Peter P. Toth, Steven R. Jones, Giuseppe Lippi, Kazuhiko Kotani, Karam Kostner, Manfredi Rizzo, Jacek Rysz and Maciej Banach contributed to the interpretation of the work and revised the manuscript critically for important intellectual content. All authors have approved the final manuscript and agree to be held accountable for all aspects of the work.

Conflicts of interest

This meta-analysis was written independently; no company or institution supported it financially. Dr. Penson owns four shares in AstraZeneca PLC, which he inherited during 2015. Dr. Toth is a member of the speakers’ bureau for Amarin, Amgen, Merck, and Regeneron-Sanofi; and a consultant to Amarin, Amgen, AstraZeneca, Kowa, Merck, and Regeneron-Sanofi. No professional writer was involved in the preparation of this meta-analysis.

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