Mar 23, 2002

A systematic review of the skeletal effects of estrogen therapy in postmenopausal women. II. An assessment of treatment effects

Climacteric : the Journal of the International Menopause Society
D O'ConnellW Gillespie

Abstract

To combine the results of randomized controlled trials to provide overall estimates of the effect of estrogen treatment on fracture rates and measures of bone mass. Articles on estrogen treatment for osteoporosis published between 1977 and 1995 were identified. Studies selected were randomized controlled trials of the efficacy of estrogens in preventing loss of bone mass or fractures in postmenopausal women. Data extraction and quality assessment were performed in duplicate, with assistance of a manual. Raters were blinded as to authors and their affiliations and the publication details. With estimates of bone mass, the treatment effect size was defined as the difference in the mean annual change in bone mass between the treatment and control groups divided by the pooled standard deviation for change. In the case of fractures, efficacy was measured as the reduction in the numbers of individuals experiencing new fractures with treatment. Effect sizes were pooled using the random effects model. Thirty-seven studies met the criteria for inclusion in the systematic review. Only one small secondary prevention trial contained evaluable data on vertebral fractures. This study found a fracture relative risk of 0.63 (95% confidence inte...Continue Reading

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Citations

Mentioned in this Paper

Progestogens, endocrine therapy drugs
Calcium [EPC]
Osteoporosis, Postmenopausal
Calcium
Dose-response Relationship
Spinal Fractures
Androgens
Skeletal System
Bone Mineral Density Test
Estrogens, endocrine therapy drugs

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