Literature DB >> 20547017

Effects of continuous combined hormone replacement therapy and clodronate on bone mineral density in osteoporotic postmenopausal women: a 5-year follow-up.

Marjo Tuppurainen1, Kirsi Härmä, Marja Komulainen, Vesa Kiviniemi, Heikki Kröger, Risto Honkanen, Esko Alhava, Jukka Jurvelin, Seppo Saarikoski.   

Abstract

OBJECTIVE: To determine the effects of HRT with or without clodronate on bone mineral density (BMD) change and bone turnover markers.
DESIGN: Prospective, partly randomized trial.
SETTING: Kuopio University Hospital, Finland. POPULATION: 167 osteoporotic women (61+/-2.7 years; T-score<or=-2.5 SD).
METHODS: Estradiol 2 mg+NETA 1 mg, randomization to additional 800 mg clodronate (n=55, HT+C-group) or placebo (n=55, HT-group); if contraindications to HRT, clodronate (n=57, C-group). MAIN OUTCOME MEASURES: BMD by DXA after 1, 3 and 5 years, serum osteocalcin (OC) and bone-specific alkaline phosphatase (BAP) at the baseline and after 3 years.
RESULTS: After 5 years, adjusted lumbar BMD increased by 4.2% in the HT-group and 3.7% in the HT+C-group. The C-group showed a decrease of -1.1%, the total difference being 5.3% and 4.8% between HT, HT+C vs. C-group, respectively (p<0.001). In the femoral neck, the adjusted 5-year BMD benefit was 1.3% and 2.4% in the HT- and HT+C-groups, respectively, the net loss of BMD in the C-group was -3.3% (p<0.05 between HT+C vs. C). By 3 years, OC decreased by 55.0%, 70.3% and 53.8% in the HT-, HT+C- and C-groups, respectively (p<0.001 vs. baseline). The significant decreases of BAP were 39.4% in the HT-group, 42.1% in the HT+C-group and 30.2% in the C-group with no significant differences between the groups after adjustments.
CONCLUSIONS: In postmenopausal women with osteoporosis, HRT increased spinal and femoral BMD, but the combination of HRT and clodronate did not offer an extra gain of bone mass. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

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Year:  2010        PMID: 20547017     DOI: 10.1016/j.maturitas.2010.04.013

Source DB:  PubMed          Journal:  Maturitas        ISSN: 0378-5122            Impact factor:   4.342


  4 in total

Review 1.  The use of combination therapy in the treatment of postmenopausal osteoporosis.

Authors:  Juliet Compston
Journal:  Endocrine       Date:  2011-10-29       Impact factor: 3.633

Review 2.  Zoledronic acid in the treatment of early-stage breast cancer: is there a final verdict?

Authors:  Michael Gnant
Journal:  Curr Oncol Rep       Date:  2012-02       Impact factor: 5.075

3.  Analysis of the Influence of Hormone Replacement Therapy on Osteocalcin Gene Expression in Postmenopausal Women.

Authors:  Mansur Rahnama; Izabela Jastrzębska-Jamrogiewicz; Rafał Jamrogiewicz; Grzegorz Trybek
Journal:  Biomed Res Int       Date:  2015-08-19       Impact factor: 3.411

4.  A fall in the previous 12 months predicts fracture in the subsequent 5 years in postmenopausal women.

Authors:  N Afrin; R Sund; R Honkanen; H Koivumaa-Honkanen; T Rikkonen; L Williams; H Kröger
Journal:  Osteoporos Int       Date:  2019-12-19       Impact factor: 4.507

  4 in total

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