Effect of hormone therapy on the risk of bone fractures: a systematic review and meta-analysis of randomized controlled trials

@article{Zhu2016EffectOH,
  title={Effect of hormone therapy on the risk of bone fractures: a systematic review and meta-analysis of randomized controlled trials},
  author={Linlin Zhu and Xinyan Jiang and Yuhong Sun and Wenhuan Shu},
  journal={Menopause},
  year={2016},
  volume={23},
  pages={461–470}
}
Objective:The aim of this study was to investigate the association between hormone therapy (HT) use and the development of bone fractures. Methods:Using terms related to HT and fractures, we searched PubMed, Embase, and the Cochrane library for randomized controlled trials on HT and the associated risk of fractures published before August 2014. Two evaluators independently selected studies on the basis of predetermined selection criteria, and 28 studies were included in the meta-analysis… 
Effect of estrogen replacement therapy on bone and cardiovascular outcomes in women with turner syndrome: a systematic review and meta-analysis
TLDR
The current evidence suggests possible benefit of estrogen replacement therapy on bone mineral density and high density lipoprotein cholesterol, but whether this improvement translates into changes in patient important outcomes (cardiovascular events or fractures) remains uncertain.
Menopausal hormone therapy and women’s health: An umbrella review
TLDR
An umbrella review to comprehensively summarize evidence on the benefits and harms of MHT across diverse health outcomes found that MHT has a complex balance of benefits and harm on multiple health outcomes.
Gonadal Hormones in the Pathogenesis and Treatment of Bone Health in Patients with Chronic Kidney Disease: a Systematic Review and Meta-Analysis
TLDR
There is evidence that raloxifene treatment may be beneficial in improving BMD in post-menopausal women with CKD, and there is insufficient evidence for other hormone treatments in men or women.
Hysterectomies are associated with an increased risk of osteoporosis and bone fracture: A population-based cohort study
TLDR
It is found that hysterectomized women might be associated with increased risks of developing osteoporosis or bone fracture.
Osteoporotic Fractures in Postmenopausal Women
To the Editor: The primary outcome results that Lv and colleagues presented indicate that serum 25-hydroxy vitamin D levels were significantly (P < .001) lower in participants with hip fracture than
The effect of exercise intensity on bone in postmenopausal women (part 1): A systematic review.
TLDR
Heterogeneity in both study quality and outcomes limits the ability to draw strong conclusions from this comprehensive systematic review of RCT and CT reports, but there is a tendency in the higher quality data to indicate exercise intensity is positively related to the adaptive bone response.
Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause.
TLDR
It is proposed that HRT should be considered as part of a general prevention strategy for women at the onset of menopause, showing that younger women have many benefits and few risks, particularly if therapy is predominantly focused on the estrogen component.
Update on Menopausal Hormone Therapy for Fracture Prevention
TLDR
Menopausal hormone therapy should be considered in women with premature estrogen deficiency and increased risk of bone loss and osteoporotic fractures, but use is hindered by increase in breast cancer risk even in women younger than 60 years old or who are within 10 years of menopause onset.
Hormone therapy in the postmenopausal years: considering benefits and risks in clinical practice.
TLDR
HT is an effective treatment for bothersome menopausal vasomotor symptoms, genitourinary syndrome, and prevention of osteoporotic fractures and can improve bothersome symptoms, all the while conferring offset benefits such as cardiovascular risk reduction and a reduction in bone fracture risk.
Hormone-replacement therapy: current thinking
  • R. Lobo
  • Medicine
    Nature Reviews Endocrinology
  • 2017
TLDR
In younger healthy women (aged 50–60 years), the risk–benefit balance is positive for using HRT, with risks considered rare, and some consideration might be given to HRT as a prevention strategy as treatment can reduce CHD and all-cause mortality.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 59 REFERENCES
Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomised trials
TLDR
A review and meta-analysis of randomised trials of HRT showed a significant reduction in vertebral fractures associated with HRT use.
Hormone replacement therapy and prevention of nonvertebral fractures: a meta-analysis of randomized trials.
TLDR
The authors' meta-analysis of randomized controlled trials of HRT noted a statistically significant reduction in nonvertebral fractures, however, this effect may be attenuated in older women.
Hormone replacement therapy and risk of hip fracture: population based case-control study. The Swedish Hip Fracture Study Group.
TLDR
Recent use of hormone replacement therapy is required for optimum fracture protection, but therapy can be started several years after the menopause, and an oestrogen-sparing effect is achieved when progestins are included in the regimen.
Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial.
TLDR
It is demonstrated that estrogen plus progestin increases BMD and reduces the risk of fracture in healthy postmenopausal women and there was no net benefit when considering the effects of hormone therapy on other important disease outcomes in a global model.
Estrogen replacement therapy and fractures in older women. Study of Osteoporotic Fractures Research Group.
TLDR
Current use of estrogen appears to decrease the risk for fracture in older women, and it is suggested that for protection against fractures, estrogen should be initiated soon after menopause and continued indefinitely.
Effects of hormone replacement therapy on clinical fractures and height loss: The Heart and Estrogen/Progestin Replacement Study (HERS).
TLDR
There was no evidence of a reduction in the incidence of fractures or rate of height loss in older women not selected for osteoporosis in the Heart Estrogen/progestin Replacement Study, a randomized double-blind, placebo-controlled secondary prevention trial of cardiovascular disease.
Hormone replacement therapy and the risk for first hip fracture. A prospective, population-based cohort study.
TLDR
Treatment with potent estrogens, both alone and possibly when combined with progestogens, reduces the risk for both cervical and trochanteric hip fractures within the first decade after menopause.
A four-year randomized controlled trial of hormone replacement and bisphosphonate, alone or in combination, in women with postmenopausal osteoporosis.
TLDR
An additive effect of etidronate and HRT on hip and spine BMD in postmenopausal women with established osteoporosis was showed, showing a trend toward a lower rate of new vertebral fractures in the treatment groups.
HRT and Vit D in prevention of non-vertebral fractures in postmenopausal women; a 5 year randomized trial.
TLDR
This study is the first prospective trial confirming the beneficial effect of HRT on prevention of peripheral fractures in non-osteoporotic postmenopausal women.
Effects of hormone therapy on bone mineral density: results from the postmenopausal estrogen/progestin interventions (PEPI) trial. The Writing Group for the PEPI.
  • Medicine
    JAMA
  • 1996
TLDR
Findings demonstrate that estrogen replacement therapy increases BMD at clinically important sites, similar among those adhering to assigned therapy, and among adherent participants, there were no significant differences in BMD changes among the 4 active treatment groups.
...
1
2
3
4
5
...