A randomized study of tibolone on bone mineral density in osteoporotic postmenopausal women with previous fractures.
OBJECTIVE
To investigate the effects of tibolone on trabecular and cortical bone mineral density and on indices of calcium metabolism in postmenopausal women with previous fractures.


METHODS
In a 2-year, randomized, double-blind, placebo-controlled, bicenter study, 45 women were treated with tibolone and 43 with placebo. All subjects received 800 mg of calcium daily. Trabecular bone mineral density of lumbar spine (L1 to L4) and cortical bone mass at the femoral neck were assessed by dual energy x-ray absorptiometry at baseline and at 6-month intervals. Serum and urinary bone biochemistry variables were also assessed.


RESULTS
After 2 years, subjects in the tibolone group gained 6.9% bone mass at lumbar spine and 4.5% at femoral neck, and respective increases from baseline in the placebo group were 2.7% and 1.4%. Tibolone-treated patients gained statistically significantly more bone mass than placebo-treated patients in the spine and femur. Urinary calcium: creatinine and hydroxyproline:creatinine ratios, as well as serum alkaline phosphatase and phosphate levels, were significantly reduced with tibolone compared with placebo.


CONCLUSIONS
Tibolone induced a significant increase in trabecular (lumbar spine) and cortical (femoral neck) bone mass in postmenopausal osteoporotic women compared to placebo, suggesting its potential to treat postmenopausal osteoporosis.
Department of Obstetrics and Gynecology, Chelsea and Westminster Hospital, London, United Kingdom.
J
J
Studd
I
I
Arnala
P M
PM
Kicovic
D
D
Zamblera
H
H
Kröger
N
N
Holland
D000368:Aged; D045930:Anabolic Agents / Q000494:pharmacology*; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D009652:Norpregnenes / Q000494:pharmacology*; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*
D045930:Anabolic Agents; D009652:Norpregnenes; C027385:tibolone; D002118:Calcium