The effect of low dose nylestriol-levonorgestrel replacement therapy on bone mineral density in women with postmenopausal osteoporosis.
OBJECTIVE
Recently our studies have shown that nylestriol in combination with levonorgestrel prevented bone loss, decreased bone turnover rate and increased the maximal loading of bone without obvious side effects in retinoic acid (RA) induced osteoporotic rats. In addition to the animal experiments, we evaluate the effect of Compound Nylestriol Tablet (CNT) on bone mineral density (BMD) in women with postmenopausal osteoporosis. Compound Nylestriol Tablet, which contains 0.5 mg of nylestriol (cyclopentylethinyl estriol) and 0.15 mg of levonorgestrel per tablet, was authorized as a new anti-osteoporotic agent for clinical trial in postmenopausal osteoporosis.


METHODS
One year's clinical observation was performed in 191 eligible patients who were randomly divided into two groups (A and B). In group A, 119 patients were treated for one year with CNT (one tablet per week) and in group B, 72 patients with placebo. Bone mineral density of lumbar antero-posterior spine (L1-L4), lateral spine, total hip and total forearm positions including radius+ulna at the ultra distal areas, mid areas, and one-third areas, were measured before and after treatment. Biochemical parameters and effects of CNT on uterus, and breast were observed.


RESULTS
We found that patients treated with CNT had a significant decrease of bone loss in total forearm, including radius+ulna at the ultra distal, mid, and 1/3 areas compared with control subjects (all P < 0.05). An improved BMD tendency could be seen at the lumbar spine. There were no differences in the observed biochemical variables. No side-effects on uterus, or mammary glands observed. None of the patients had uterine bleeding or vertebral fractures during one year's CNT treatment.


CONCLUSIONS
These data suggested that CNT is effective, safe and convenient in treating postmenopausal osteoporosis.
Liao
Er-yuan
EY
Institute of Endocrinology & Metabolism, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China.
Luo
Xiang-hang
XH
Deng
Xiao-ge
XG
Wu
Xian-ping
XP
Liao
Hui-juan
HJ
Wang
Ping-fang
PF
Mao
Ji-ping
JP
Zhu
Xu-ping
XP
Huang
Gan
G
Wei
Qi-you
QY
D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000187:drug effects; D001940:Breast / Q000187:drug effects; D003280:Contraceptives, Oral, Synthetic / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D004717:Endometrium / Q000187:drug effects; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000517:prevention & control; D017698:Postmenopause / Q000187:drug effects*; D011446:Prospective Studies; D011800:Quinestrol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D003280:Contraceptives, Oral, Synthetic; D004338:Drug Combinations; D016912:Levonorgestrel; C010722:nylestriol; D011800:Quinestrol