Oestrogen plus progestin significantly improves bone mineral density and reduces risk of fracture - 24/08/11

Doi : 10.1016/j.ehbc.2004.02.004

Birgitta Tengstrand, MD, PhD : Commentary Author
Department of Rheumatology, Karolinska University Hospital/Huddinge, 141 86 Stockholm, Sweden

Abstract

Question

Does oestrogen plus progestin affect bone mineral density and the risk of fracture in healthy post-menopausal women?

Study design

Double blind randomised controlled trial.

Main results

Hormone therapy significantly reduced the risk of fracture compared with placebo. Hormone therapy reduced the risk of hip fracture by 33% (see Table 1). At 3 years, bone mineral density (BMD) improved in the hormone group compared with placebo (increase in hip BMD 3.7% vs. 0.14%, mean difference 3.6%, p<0.001; mean difference in lumbar spine BMD 4.5%).

Table 1 Number of fractures and hazard ratios for fractures at specific sites.
	Hormone therapy N=8506	Placebo N=8102	Hazard ratio, hormone group vs. placebo (95% CI)
Total number of fractures (%)	733 (8.6%)	896 (11.1%)	0.76 (0.69 to 0.83)
Number of hip fractures (%)	52 (0.6%)	73 (0.9%)	0.67 (0.47 to 0.96)
Number of lower arm/wrist fractures (%)	189 (2.2%)	245 (3.0%)	0.71 (0.59 to 0.85)
Number of vertebral fractures	41 (0.5%)	60 (0.7%)	0.65 (0.46 to 0.92)

Authors’ conclusions

Oestrogen plus progestin significantly increased bone mineral density and reduced risk of fracture in healthy post-menopausal women.

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Keywords : Oestrogen replacement therapy, Osteoporosis, Fractures, Postmenopausal women, Randomised controlled trial

Plan

Commentary

Study parameters

Abstracted from: Cauley JA, Robbins J, Chen Z, et al. Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial. JAMA 2003; 290: 1729–1738.