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Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1‐year controlled trial
Author(s) -
Pereira S. P.,
O'Donohue J.,
Moniz C.,
Phillips M. G.,
Abraha H.,
BuxtonThomas M.,
Williams R.
Publication year - 2004
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2004.01890.x
Subject(s) - medicine , deoxypyridinoline , hormone replacement therapy (female to male) , osteoporosis , bone density , bone remodeling , osteopenia , bone mineral , urology , urinary calcium , creatinine , gastroenterology , endocrinology , osteocalcin , testosterone (patch) , biochemistry , chemistry , alkaline phosphatase , enzyme
Summary Background : Retrospective studies have suggested that hormone replacement therapy may reduce the rate of bone loss in primary biliary cirrhosis, but no controlled data are available. Methods : Forty‐two post‐menopausal women with primary biliary cirrhosis were treated with calcium and vitamin D, either alone ( n = 21) or together with transdermal hormone replacement therapy ( n = 21). Bone densitometry was performed at baseline and at 1 year, and serum and urinary markers of bone turnover were measured at three‐monthly intervals. Results : At entry, 17 patients (40%) had spinal or femoral osteopenia (T score − 1 to − 2.5) and nine (21%) had osteoporosis (T < − 2.5). In those given hormone replacement therapy, there was a significant decrease in the mean urinary deoxypyridinoline :creatinine ratios at 3 months (7.8 vs. 6.1 n m /m m creatinine for no hormone replacement therapy vs. hormone replacement therapy; P = 0.04) and a 48% reduction in urinary calcium excretion at 1 year (0.66 vs. 0.32 m m /m m creatinine; P = 0.01). Repeat bone densitometry at 1 year revealed a 2.25% increase in the hormone replacement therapy group ( P = 0.02), compared with a non‐significant 0.87% decrease in L2–L4 bone mineral density in those not given hormone replacement therapy. Both treatment regimens were well tolerated, with no increase in cholestasis. Conclusions : Compared with calcium and vitamin D alone, supplemental treatment with transdermal hormone replacement therapy for 1 year improved the vertebral bone density and urinary markers of bone turnover in post‐menopausal women with primary biliary cirrhosis.