title: Comparison of combined low-dose hormone therapy vs. tibolone in the prevention of bone loss.
abstract: OBJECTIVE
  To compare the effects on bone mineral density (BMD) measured by dual-energy X-ray absorptiometry at the lumbar spine, the femoral neck and the total hip following 2 years of treatment with a low-dose combined hormone therapy (HT) comprised of 1 mg estradiol and 0.5 mg norethisterone acetate (E2/NETA) versus 2.5 mg tibolone in postmenopausal women. Additionally, quantitative ultrasonometry (QUS) of the os calcaneus and of the phalanges was performed.
  
  
  METHODS
  Changes in BMD, QUS and side-effects were assessed at baseline, 6, 12 and 24 months in 50 postmenopausal women who received either E2/NETA (n = 26) or tibolone (n = 24) for 2 years.
  
  
  RESULTS
  Compared to women on tibolone, women receiving E2/NETA showed a significant increase in BMD from baseline to 12 and 24 months at the lumbar spine (3.07%, 3.86%; p < 0.01 vs. 1.13%, 2.23%; p < 0.05), and at the total hip (1.33%, 1.69%; p < 0.01 vs. 0.76%, 0.70%) and at the femoral neck from baseline to 24 months (1.10%; p < 0.05). QUS indices only showed a significant change with the ultrasound bone profile index with E2/NETA at 6 months (-2.32%; p < 0.001).
  
  
  CONCLUSIONS
  Low-dose E2/NETA showed a significantly higher increase in BMD compared to tibolone. QUS measurement was not considered to comprise beneficial effects in monitoring drug-induced bone changes.
authors.affiliation: a Department of Obstetrics and Gynecology , Philipps University of Marburg , Germany ;
authors.forename: M
authors.initials: M
authors.lastname: Kalder
authors.affiliation: a Department of Obstetrics and Gynecology , Philipps University of Marburg , Germany ;
authors.forename: I
authors.initials: I
authors.lastname: Kyvernitakis
authors.affiliation: b Statistical Institute , Berlin , Germany ;
authors.forename: O
authors.initials: O
authors.lastname: Hars
authors.affiliation: a Department of Obstetrics and Gynecology , Philipps University of Marburg , Germany ;
authors.forename: A
authors.initials: A
authors.lastname: Kauka
authors.affiliation: c Department of Bone Oncology, Endocrinology and Reproductive Medicine , Nordwest Hospital , Frankfurt , Germany.
authors.forename: P
authors.initials: P
authors.lastname: Hadji
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage* / Q000009:adverse effects; D009652:Norpregnenes / Q000008:administration & dosage* / Q000009:adverse effects; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000209:etiology
chemical_list: D009652:Norpregnenes; D004958:Estradiol; C027385:tibolone; D009640:Norethindrone
keywords: Hormone therapy; bone mineral density; osteoporosis; tibolone