V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women

George A. Wells, Peter Tugwell, Beverley J. Shea, Gordon H Guyatt, Joan Peterson, Nicole Zytaruk, Vivian Robinson, David Henry, Diane O'Connell, Ann Cranney, Jonathan Adachi, Lauren Griffith, Jessie McGowan, Bruce Weaver, Andrew Willan, Clifford J. Rosen, John P. Bilezikian, Dennis M. Black, Murray J. Favus, Lorraine A. Fitzpatrick & 4 others Douglas P. Kiel, Robert Marcus, Eric S. Orwoll, Thomas J. Schnitzer

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Abstract

Objective: To review the effect of hormone replacement therapy (HRT) on bone density and fractures in postmenopausal women. Data Source: We searched MEDLINE and EMBASE from 1966 to 1999, the Cochrane Controlled Register, citations of relevant articles, and proceedings of international meetings for eligible randomized controlled trials. We contacted osteoporosis investigators to identify additional studies, and primary authors for unpublished data. Study Selection: We included 57 studies that randomized postmenopausal women to HRT or a control (placebo or calcium/vitamin D) and were of at least 1 yr in duration. Seven of these studies reported fractures. Data Abstraction: For each study, three independent reviewers assessed the methodological quality and abstracted the data. Data Synthesis: HRT showed a trend toward reduced incidence of vertebral fractures [relative risk (RR) 0.66, 95% confidence interval (CI) 0.41-1.07; 5 trials] and nonvertebral fractures (RR 0.87, 95% CI 0.71-1.08; 6 trials). HRT had a consistent effect on bone mineral density (BMD) at all sites. The difference between HRT and control in the percent change in bone density at 2 yr was 6.76 (5.83, 7.89; 21 trials) at the lumbar spine and 4.53 (3.68, 5.36; 14 trials) and 4.12 (3.45, 4.80; 9 trials) at the forearm and femoral neck, respectively. Conclusions: HRT has a consistent, favorable and large effect on bone density at all sites. The data show a nonsignificant trend toward a reduced incidence in vertebral and nonvertebral fractures.

Original languageEnglish
Pages (from-to)529-539
Number of pages11
JournalEndocrine Reviews
Volume23
Issue number4
DOIs
Publication statusPublished - 1 Aug 2002
Externally publishedYes

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Postmenopausal Osteoporosis
Hormone Replacement Therapy
Meta-Analysis
Bone Density
Confidence Intervals
Information Storage and Retrieval
Femur Neck
Bone Fractures
Incidence
Forearm
Vitamin D
MEDLINE
Osteoporosis
Spine
Randomized Controlled Trials
Placebos
Research Personnel
Calcium

Cite this

Wells, G. A., Tugwell, P., Shea, B. J., Guyatt, G. H., Peterson, J., Zytaruk, N., ... Schnitzer, T. J. (2002). V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women. Endocrine Reviews, 23(4), 529-539. https://doi.org/10.1210/er.2001-5002
Wells, George A. ; Tugwell, Peter ; Shea, Beverley J. ; Guyatt, Gordon H ; Peterson, Joan ; Zytaruk, Nicole ; Robinson, Vivian ; Henry, David ; O'Connell, Diane ; Cranney, Ann ; Adachi, Jonathan ; Griffith, Lauren ; McGowan, Jessie ; Weaver, Bruce ; Willan, Andrew ; Rosen, Clifford J. ; Bilezikian, John P. ; Black, Dennis M. ; Favus, Murray J. ; Fitzpatrick, Lorraine A. ; Kiel, Douglas P. ; Marcus, Robert ; Orwoll, Eric S. ; Schnitzer, Thomas J. / V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women. In: Endocrine Reviews. 2002 ; Vol. 23, No. 4. pp. 529-539.
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abstract = "Objective: To review the effect of hormone replacement therapy (HRT) on bone density and fractures in postmenopausal women. Data Source: We searched MEDLINE and EMBASE from 1966 to 1999, the Cochrane Controlled Register, citations of relevant articles, and proceedings of international meetings for eligible randomized controlled trials. We contacted osteoporosis investigators to identify additional studies, and primary authors for unpublished data. Study Selection: We included 57 studies that randomized postmenopausal women to HRT or a control (placebo or calcium/vitamin D) and were of at least 1 yr in duration. Seven of these studies reported fractures. Data Abstraction: For each study, three independent reviewers assessed the methodological quality and abstracted the data. Data Synthesis: HRT showed a trend toward reduced incidence of vertebral fractures [relative risk (RR) 0.66, 95{\%} confidence interval (CI) 0.41-1.07; 5 trials] and nonvertebral fractures (RR 0.87, 95{\%} CI 0.71-1.08; 6 trials). HRT had a consistent effect on bone mineral density (BMD) at all sites. The difference between HRT and control in the percent change in bone density at 2 yr was 6.76 (5.83, 7.89; 21 trials) at the lumbar spine and 4.53 (3.68, 5.36; 14 trials) and 4.12 (3.45, 4.80; 9 trials) at the forearm and femoral neck, respectively. Conclusions: HRT has a consistent, favorable and large effect on bone density at all sites. The data show a nonsignificant trend toward a reduced incidence in vertebral and nonvertebral fractures.",
author = "Wells, {George A.} and Peter Tugwell and Shea, {Beverley J.} and Guyatt, {Gordon H} and Joan Peterson and Nicole Zytaruk and Vivian Robinson and David Henry and Diane O'Connell and Ann Cranney and Jonathan Adachi and Lauren Griffith and Jessie McGowan and Bruce Weaver and Andrew Willan and Rosen, {Clifford J.} and Bilezikian, {John P.} and Black, {Dennis M.} and Favus, {Murray J.} and Fitzpatrick, {Lorraine A.} and Kiel, {Douglas P.} and Robert Marcus and Orwoll, {Eric S.} and Schnitzer, {Thomas J.}",
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Wells, GA, Tugwell, P, Shea, BJ, Guyatt, GH, Peterson, J, Zytaruk, N, Robinson, V, Henry, D, O'Connell, D, Cranney, A, Adachi, J, Griffith, L, McGowan, J, Weaver, B, Willan, A, Rosen, CJ, Bilezikian, JP, Black, DM, Favus, MJ, Fitzpatrick, LA, Kiel, DP, Marcus, R, Orwoll, ES & Schnitzer, TJ 2002, 'V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women', Endocrine Reviews, vol. 23, no. 4, pp. 529-539. https://doi.org/10.1210/er.2001-5002

V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women. / Wells, George A.; Tugwell, Peter; Shea, Beverley J.; Guyatt, Gordon H; Peterson, Joan; Zytaruk, Nicole; Robinson, Vivian; Henry, David; O'Connell, Diane; Cranney, Ann; Adachi, Jonathan; Griffith, Lauren; McGowan, Jessie; Weaver, Bruce; Willan, Andrew; Rosen, Clifford J.; Bilezikian, John P.; Black, Dennis M.; Favus, Murray J.; Fitzpatrick, Lorraine A.; Kiel, Douglas P.; Marcus, Robert; Orwoll, Eric S.; Schnitzer, Thomas J.

In: Endocrine Reviews, Vol. 23, No. 4, 01.08.2002, p. 529-539.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women

AU - Wells, George A.

AU - Tugwell, Peter

AU - Shea, Beverley J.

AU - Guyatt, Gordon H

AU - Peterson, Joan

AU - Zytaruk, Nicole

AU - Robinson, Vivian

AU - Henry, David

AU - O'Connell, Diane

AU - Cranney, Ann

AU - Adachi, Jonathan

AU - Griffith, Lauren

AU - McGowan, Jessie

AU - Weaver, Bruce

AU - Willan, Andrew

AU - Rosen, Clifford J.

AU - Bilezikian, John P.

AU - Black, Dennis M.

AU - Favus, Murray J.

AU - Fitzpatrick, Lorraine A.

AU - Kiel, Douglas P.

AU - Marcus, Robert

AU - Orwoll, Eric S.

AU - Schnitzer, Thomas J.

PY - 2002/8/1

Y1 - 2002/8/1

N2 - Objective: To review the effect of hormone replacement therapy (HRT) on bone density and fractures in postmenopausal women. Data Source: We searched MEDLINE and EMBASE from 1966 to 1999, the Cochrane Controlled Register, citations of relevant articles, and proceedings of international meetings for eligible randomized controlled trials. We contacted osteoporosis investigators to identify additional studies, and primary authors for unpublished data. Study Selection: We included 57 studies that randomized postmenopausal women to HRT or a control (placebo or calcium/vitamin D) and were of at least 1 yr in duration. Seven of these studies reported fractures. Data Abstraction: For each study, three independent reviewers assessed the methodological quality and abstracted the data. Data Synthesis: HRT showed a trend toward reduced incidence of vertebral fractures [relative risk (RR) 0.66, 95% confidence interval (CI) 0.41-1.07; 5 trials] and nonvertebral fractures (RR 0.87, 95% CI 0.71-1.08; 6 trials). HRT had a consistent effect on bone mineral density (BMD) at all sites. The difference between HRT and control in the percent change in bone density at 2 yr was 6.76 (5.83, 7.89; 21 trials) at the lumbar spine and 4.53 (3.68, 5.36; 14 trials) and 4.12 (3.45, 4.80; 9 trials) at the forearm and femoral neck, respectively. Conclusions: HRT has a consistent, favorable and large effect on bone density at all sites. The data show a nonsignificant trend toward a reduced incidence in vertebral and nonvertebral fractures.

AB - Objective: To review the effect of hormone replacement therapy (HRT) on bone density and fractures in postmenopausal women. Data Source: We searched MEDLINE and EMBASE from 1966 to 1999, the Cochrane Controlled Register, citations of relevant articles, and proceedings of international meetings for eligible randomized controlled trials. We contacted osteoporosis investigators to identify additional studies, and primary authors for unpublished data. Study Selection: We included 57 studies that randomized postmenopausal women to HRT or a control (placebo or calcium/vitamin D) and were of at least 1 yr in duration. Seven of these studies reported fractures. Data Abstraction: For each study, three independent reviewers assessed the methodological quality and abstracted the data. Data Synthesis: HRT showed a trend toward reduced incidence of vertebral fractures [relative risk (RR) 0.66, 95% confidence interval (CI) 0.41-1.07; 5 trials] and nonvertebral fractures (RR 0.87, 95% CI 0.71-1.08; 6 trials). HRT had a consistent effect on bone mineral density (BMD) at all sites. The difference between HRT and control in the percent change in bone density at 2 yr was 6.76 (5.83, 7.89; 21 trials) at the lumbar spine and 4.53 (3.68, 5.36; 14 trials) and 4.12 (3.45, 4.80; 9 trials) at the forearm and femoral neck, respectively. Conclusions: HRT has a consistent, favorable and large effect on bone density at all sites. The data show a nonsignificant trend toward a reduced incidence in vertebral and nonvertebral fractures.

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U2 - 10.1210/er.2001-5002

DO - 10.1210/er.2001-5002

M3 - Review article

VL - 23

SP - 529

EP - 539

JO - Endocrine Reviews

JF - Endocrine Reviews

SN - 0079-9963

IS - 4

ER -