Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1-year controlled trial.

Abstract

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 nm/mm 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 mm/mm 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.

• Authors: S P Pereira, J O'Donohue, C Moniz, M G Phillips, H Abraha, M Buxton-Thomas, R Williams
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 19 Issue 5 Pg. 563-70 (Mar 01 2004) ISSN: 0269-2813 [Print] England
• PMID: 14987325 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)

Chemical References

• Amino Acids
• deoxypyridinoline

Topics

• Administration, Cutaneous
• Aged
• Amino Acids (urine)
• Bone Density (drug effects)
• Bone Remodeling (drug effects)
• Female
• Hormone Replacement Therapy (adverse effects, methods)
• Humans
• Liver Cirrhosis, Biliary (drug therapy, physiopathology)
• Middle Aged
• Prospective Studies