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Targeting of hormone replacement therapy immediately after menopause

Johnell, Olof LU ; Kanis, J A ; Oden, A ; Redlund-Johnell, Inga LU ; Hasserius, Ralph LU ; Sernbo, Ingemar LU and Caulin, F (2001) In Bone 28(4). p.440-445
Abstract
The aim of this study was to model the effect of short (3-year) treatments with hormone replacement therapy (HRT) at the time of menopause on the risk of osteoporotic fracture, and to assess the impact of strategies to target high-risk individuals. From the relationship between bone mineral density (BMD) and fracture risk, treatment that increased bone mineral density at the hip by 6% over untreated women would save 35 vertebral, 62 hip, 13 proximal humeral, and 16 forearm fractures per 1000 women. The number needed to treat (NNT) to prevent one of these fractures was 8. The NNT fell modestly by targeting HRT to women with low bone mass or osteoporosis (NNT 6 and 5, respectively). The gains in fractures saved from targeting women with low... (More)
The aim of this study was to model the effect of short (3-year) treatments with hormone replacement therapy (HRT) at the time of menopause on the risk of osteoporotic fracture, and to assess the impact of strategies to target high-risk individuals. From the relationship between bone mineral density (BMD) and fracture risk, treatment that increased bone mineral density at the hip by 6% over untreated women would save 35 vertebral, 62 hip, 13 proximal humeral, and 16 forearm fractures per 1000 women. The number needed to treat (NNT) to prevent one of these fractures was 8. The NNT fell modestly by targeting HRT to women with low bone mass or osteoporosis (NNT 6 and 5, respectively). The gains in fractures saved from targeting women with low bone mass or osteoporosis were offset by the requirement for assessment by BMD. Changes in the assumptions about the efficacy of HRT had a modest impact on fractures saved compared with the effect of changing assumptions concerning the offset of effect when treatment was stopped. We conclude that comparatively short courses of HRT might be effectively offered to all suitable women at menopause provided that the effects on bone persist when treatment is stopped. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Offset of effect, Number needed to treat (NNT), Bone material density, Hormone replacement therapy, Fractures
in
Bone
volume
28
issue
4
pages
440 - 445
publisher
Elsevier
external identifiers
  • pmid:11336926
  • scopus:0035032405
ISSN
1873-2763
DOI
10.1016/S8756-3282(01)00418-5
language
English
LU publication?
yes
id
f5e08790-c969-4de9-b1b2-697215a5c3b1 (old id 1121430)
date added to LUP
2016-04-01 16:21:51
date last changed
2022-01-28 19:12:14
@article{f5e08790-c969-4de9-b1b2-697215a5c3b1,
  abstract     = {{The aim of this study was to model the effect of short (3-year) treatments with hormone replacement therapy (HRT) at the time of menopause on the risk of osteoporotic fracture, and to assess the impact of strategies to target high-risk individuals. From the relationship between bone mineral density (BMD) and fracture risk, treatment that increased bone mineral density at the hip by 6% over untreated women would save 35 vertebral, 62 hip, 13 proximal humeral, and 16 forearm fractures per 1000 women. The number needed to treat (NNT) to prevent one of these fractures was 8. The NNT fell modestly by targeting HRT to women with low bone mass or osteoporosis (NNT 6 and 5, respectively). The gains in fractures saved from targeting women with low bone mass or osteoporosis were offset by the requirement for assessment by BMD. Changes in the assumptions about the efficacy of HRT had a modest impact on fractures saved compared with the effect of changing assumptions concerning the offset of effect when treatment was stopped. We conclude that comparatively short courses of HRT might be effectively offered to all suitable women at menopause provided that the effects on bone persist when treatment is stopped.}},
  author       = {{Johnell, Olof and Kanis, J A and Oden, A and Redlund-Johnell, Inga and Hasserius, Ralph and Sernbo, Ingemar and Caulin, F}},
  issn         = {{1873-2763}},
  keywords     = {{Offset of effect; Number needed to treat (NNT); Bone material density; Hormone replacement therapy; Fractures}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{440--445}},
  publisher    = {{Elsevier}},
  series       = {{Bone}},
  title        = {{Targeting of hormone replacement therapy immediately after menopause}},
  url          = {{http://dx.doi.org/10.1016/S8756-3282(01)00418-5}},
  doi          = {{10.1016/S8756-3282(01)00418-5}},
  volume       = {{28}},
  year         = {{2001}},
}