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Hormone Therapy Plus Alendronate Better for Bone Density than Hormone Therapy Alone: Presented at NAMS
By W. A. Thomasson
Special to DG News
CHICAGO, IL -- October 8, 2002 -- Either oral or transdermal estrogen-progestin therapy improves bone mineral density in postmenopausal women, but the improvement is greater when alendronate is added to the therapy.
This was the conclusion of a study presented Friday at the annual meeting of the North American Menopause Society by Ahmet Varolan, MD, and colleagues at Sisli Etfal Training and Research Hospital in Istanbul, Turkey.
The study enrolled 173 women (13 unevaluable due to noncompliance) who had climacteric complaints, were at least one year past the last menses, and had a vertebral bone mineral T-score of -1 or lower.
All patients received oral medroxyprogesterone acetate 5 mg/day -- half received conjugated estrogens 0.625 mg/day orally, the other half 0.05 mg of transdermal estrogen twice a week. Half the patients in each group also received alendronate 10 mg/day. Results were analyzed separately for women who were osteopenic (-2.5 < T-score < -1) and those who were osteoporotic (T-score < -2.5). Results were also analyzed separately for osteopenic women with T-score < -1.5 and those with -1.5 < T-score < -1.
Bone mineral density was re-evaluated at the end of one year of treatment. An increase was found in all treatment groups, regardless of initial T-scores, although the increase was greater in women with initially lower bone density. The extent of the increase did not vary significantly with the type of estrogen treatment. In all cases, however, the increase was significantly greater in patients who received alendronate than in those who did not.
Thus, the authors concluded, although hormone therapy alone is clearly beneficial in osteopenic or osteoporotic postmenopausal women, combined hormone and alendronate therapy is the preferred choice.
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