0
Sign In  | Subscribe
3 December 2002, Vol 137, No. 11>
Summaries for Patients | 3 December 2002

Bone Loss after Stopping Estrogen or Alendronate Therapy FREE

[+] Article and Author Information

The summary below is from the full report titled “Significant Differential Effects of Alendronate, Estrogen, or Combination Therapy on the Rate of Bone Loss after Discontinuation of Treatment of Postmenopausal Osteoporosis. A Randomized, Double-Blind, Placebo-Controlled Trial.” It is in the 3 December 2002 issue of Annals of Internal Medicine (volume 137, pages 875-883). The authors are SL Greenspan, RD Emkey, HG Bone III, SR Weiss, NH Bell, RW Downs Jr., C McKeever, SS Miller, M Davidson, MA Bolognese, AL Mulloy, N Heyden, M Wu, A Kaur, and A Lombardi.


Ann Intern Med. 2002;137(11):I-31. doi:10.7326/0003-4819-137-11-200212030-00003
Text Size: A A A

What is the problem and what is known about it so far?

Less dense and more fragile bones (osteoporosis) occur as people age. This is a big problem because bone fractures after falls or injuries happen more easily in older people with osteoporosis. There are several ways to help prevent fragile bones and fractures from osteoporosis. Adequate calcium and vitamin D intake, exercise, and avoidance of alcohol and tobacco prevent bone loss. Doctors also give drugs, such as estrogen or bisphosphonates, to prevent more bone loss in people who already have osteoporosis. Many people have difficulty taking the drugs for long periods. They may stop taking them after 1 or 2 years. The harms of stopping the drugs are not well known. For instance, does bone loss speed up after stopping either type of drug?

Why did the researchers do this particular study?

To study the rate of bone loss after stopping Premarin (an estrogen), alendronate (a bisphosphonate), and combination therapy with both drugs.

Who was studied?

244 postmenopausal women who had had their uterus removed (hysterectomy) and who had low bone mass.

How was the study done?

All of the women had participated in a 2-year trial that had compared benefits of placebo [dummy pills], Premarin, alendronate, and combination therapy. At the end of the trial, they were given the opportunity to participate in a 1-year study of stopping therapy. Those who agreed were divided into five groups. The groups switched to placebo from 1) alendronate, 2) Premarin or 3) combination therapy, or they continued 4) placebo or 5) combination therapy. The women had bone mass measurements with special x-rays at 6-month intervals. The researchers then compared bone mass between groups.

What did the researchers find?

Women receiving alendronate or combination therapy who switched to placebo did not lose bone mass. Women who switched from Premarin to placebo lost bone mass at greater rates than women who continued placebo. Women who continued taking combination therapy gained bone mass.

What were the limitations of the study?

The study was small and could not tell whether fractures would be more common in women stopping Premarin than in women stopping alendronate.

What are the implications of the study?

Bone loss speeds up after stopping Premarin but not after stopping alendronate or combination therapy with Premarin and alendronate.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Topic Collections
PubMed Articles
Summary of AHRQ's comparative effectiveness review of treatment to prevent fractures in men and women with low bone density or osteoporosis: update of the 2007 report.
Journal of managed care pharmacy : JMCP Issue date: 2012 May
Changes in serum levels of cartilage oligomeric matrix protein after estrogen and alendronate therapy in postmenopausal women.
Gynecologic and obstetric investigation Issue date: 2012

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)