CHICAGO - Hormone supplements plus a bone-building
drug work better at increasing bone density than either treatment alone in older
women, a study suggests.
The study involved 373 women ages 65 to 90 who had either thinning bones or
full-blown osteoporosis and took one of four treatments for three years:
hormones combined with alendronate, sold as Fosamax; hormones alone; Fosamax
alone; or dummy pills.
Last summer, a study was published linking hormone supplements with heart
attacks, strokes and breast cancer.
But the incidence of those problems was extremely low in the new study, said
lead author Dr. Susan Greenspan, professor of medicine at the University of
Pittsburgh. The hormones-Fosamax treatment "was safe and well-tolerated," said
Greenspan, who has worked as a consultant for Fosamax maker Merck Research
Laboratories.
Greenspan said her study suggests the hormones-Fosamax treatment may be an
option for older women who face a severe risk of osteoporosis and bone
fractures.
The findings appear in Wednesday's Journal of the American Medical
Association.
The hormone study released last summer, the Women's Health Initiative, led
many doctors to recommend against using hormone supplements for any reason other
than relief of short-term menopause symptoms. And a WHI researcher, Jennifer
Hays, said the new findings are not convincing enough to recommend hormones for
osteoporosis prevention even in older women.
Hays, a Baylor College of Medicine psychologist, said the bone-enhancing
benefits from estrogen come only after long-term use — which also carries the
highest risk of breast cancer or heart disease.
The hormones used in the Fosamax study contained estrogen alone or
estrogen-progestin.
After three years, hip bone density had increased nearly 6 percent in women
on hormones plus Fosamax, 4 percent in those on Fosamax, and 3 percent in the
hormones-only group. Increases also were seen in spinal bone density.
Higher bone density is usually associated with fewer fractures.
