The short-term effects of combined hormone replacement therapy and alendronate on bone mineral metabolism in postmenopausal women with osteoporosis / 대한내과학회지

ABSTRACT

BACKGROUND: The hormone replacement therapy (HRT) and bisphosphonate alendronate are efficacious in the prevention and treatment of postmenopausal osteoporosis. Acting by different mechanisms, these two agents decrease bone resorption and thereby increase or preserve bone mineral density. The combined effects of these medications have not been rigorously studied. This clinical trial examined the combined effects of HRT and oral alendronate on bone mineral density (BMD) and biochemical markers of bone turnover in 50 postmenopausal women with low bone mass. METHODS: This was a 1-year study in which 50 postmenopausal women received daily treatment with 0.625 mg conjugated equine estrogens (with medroxyprogesterone acetate 2.5 mg to 5 mg, daily or cyclically) alone or in combination with 10 mg alendronate. All of the women received a supplement of 600 mg elemental calcium daily. Changes in BMD at the lumbar spine and biochemical markers of bone turnover were assessed. RESULTS: At 1-year, significant increases from baseline in lumbar spine BMD were observed in both treatment groups [combined HRT and alendronate, 10.3%(p < 0.001); HRT alone, 4.5% (p < 0.05)]; Compared with HRT alone, combined HRT and alendronate significantly produced greater increases in BMD of the lumbar spine (p < 0.001). Both treatment groups significantly decreased biochemical markers of bone turnover, especially mean serum osteocalcin level and mean serum alkaline phosphatase level. The combined HRT and alendronate significantly produced greater decreases in mean serum alkaline phosphatase level than HRT alone (p < 0.05). CONCLUSION: Combined use of HRT and alendronate significantly produced greater increases in lumbar spine BMD and greater decreases in biochemical markers of bone turnover than that of HRT alone. Thus, the therapy of combined HRT and alendronate produced favorable effects on bone mineral metabolism in postmenopausal women with osteoporosis.