Change in Medication of Osteoporosis in a University Hospital after Women's Health Initiative (WHI) Clinical Trial

ABSTRACT

BACKGROUND: Recent evidence had shown from randomized trials published in July 2002 that demonstrated adverse cardiovascular disease events and other risks with hormone therapy in the form of oral estrogen combined with progestin caused limitation of its use. The purpose of this study was to describe change in medication of osteoporosis at an university hospital after the WHI clinical trial. METHODS: The study subjects were 644 and 656 women who underwent bone mass densiNometry (BMD) at an university hospital outpatient clinic in January 2002 and January 2003, respectively, with had no underlying disease for secondary osteoporosis. This study regarded January 2002 as before and Jan 2003 as after the publication of the WHI clinical trial. We analyzed change of Hormone replacement therapy (HRT), bisphosphonate, selective estrogen receptor modulator (SERM), tibolone, etc. RESULTS: More than one drug was prescribed for 425 (66%, before WHI) and 436 (66.5%, after WHI) patients among the two groups of study subjects, respectively. HRT was prescribed for 213 (33.07%) and 96 (14.63%) patients, respectively. The usage of the drugs decreased considerably after the publication of WHI clinical trial. This result was mainly due to the decline of combined estrogen/progesterone hormone therapy. The increase of bisphosphonate, SERM, calcium and vitamin D prescription was statistically significant. However, prescription for tibolone (livial) did not change. CONCLUSION: Combined estrogen/progesrerone therapy was considerably decreased after the publication of the Women's Health Initiative (WHI) clinical trial in accordance with the conclusion of the trial.