Table 8.
Effects on bone mineral density: results of studies comparing oral and transdermal administration of hormone replacement therapy
| Author, year |
Study type | Compared groups | Results |
|---|---|---|---|
| Stevenson JC et al. 1990 | Randomized controlled trial |
Group 1 o-CEE 0.625 mg/norgestrel 1.5 mg/12 days Group 2 t-E2 patch 0.05 mg/noresetisteron acetate 0.25 mg 14 days Group 3 Placebo |
Bone degradation was statistically significantly reduced in both HRT administration routes BMD increased, with no significant difference between Group 1 and 2 |
| Palacios S et al. 1994 | Randomized controlled trial |
Group 1 o-CEE 0.625 mg Group 2 t-E2 patch 1.5 mg Group 3 Placebo |
BMD increased with t-E2 by 1.7% after 12 months, 5.6% after 24 months, and 4.7% after 36 months (p < 0.001) BMD increased with o-CEE by 3.5% after 12 months and 4% after 24 months (p < 0.001) BMD loss with placebo was 6.6% after 12 months and 9.1% after 24 months (p < 0.001) |
| Cetinkaya MB et al. 2002 | Randomized controlled trial |
Group 1 o-CEE Group 2 o-CEE/MPA Group 3 t-E2 patch |
After 24 months BMD increased in all treated subjects The increase in BMD was: t-E2 2.35% (± 13.19), unopposed o-E2 1.37% (± 8.39), combined o-E2 4.08% (± 19.39) |
| Davas I et al. 2003 | Randomized controlled trial |
Group 1 o-CEE 0.625 mg/MPA 5 mg Group 2 t-E2 patch 0.05 mg/MPA 5 mg Group 3 o-CEE 0.625 mg/MPA 5 mg and alendronate Group 4 t-E2 patch 0.05 mg/MPA 5 mg and ale dronate |
BMD lumbar spine increase registered in all groups For patients with osteopenia, o-CEE increased BMD by 3.3%, and t-E2 increased BMD by 2.9% For patients with osteoporosis o-CEE increased BMD by 7.3% and t-E2 increased BMD by 6.6% Hormone therapy plus alendronate increased the BMD more in the osteoporotic group than in the osteopenic group (p = 0.001) |
| Kim H et al. 2014 | Case–control study |
Group 1 o-CEE 0.625 mg Group 2 t-E2 patch 1.5 mg or 0.1% E2 gel 1.5 mg E2 Group 3 Placebo |
After 12 months, lumbar spine BMD increased in treated groups by 3.4% with no statistically difference in Group 1 and 2 After 12 months, hip BMD increased by 2.1% with o-E2 and by 3.9% with t-E2 After 24 months, lumbar spine BMD increased by 4.8% with o-E2 and by 4.9% with t-E2 After 24 months, hip BMD increased by 3.5% with o-E2 and by 4.2% with t-E2 No difference between patch and gel on BMD values No effect on BMD values after addition of progesterone |
BMD bone mineral density, o-CEE conjugated equine estrogens, MPA medroxyprogesterone acetate