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Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials

SUMMARY: In a combined analysis of 25,389 postmenopausal women aged 50–79 years, enrolled in the two Women’s Health Initiative hormone therapy trials, menopausal hormone therapy vs. placebo reduced the risk of fracture regardless of baseline FRAX fracture probability and falls history. INTRODUCTION:...

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Autores principales: Lorentzon, Mattias, Johansson, Helena, Harvey, Nicholas C., Liu, Enwu, Vandenput, Liesbeth, Crandall, Carolyn J., Cauley, Jane A., LeBoff, Meryl S., McCloskey, Eugene V., Kanis, John A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568435/
https://www.ncbi.nlm.nih.gov/pubmed/35833956
http://dx.doi.org/10.1007/s00198-022-06483-y
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author Lorentzon, Mattias
Johansson, Helena
Harvey, Nicholas C.
Liu, Enwu
Vandenput, Liesbeth
Crandall, Carolyn J.
Cauley, Jane A.
LeBoff, Meryl S.
McCloskey, Eugene V.
Kanis, John A.
author_facet Lorentzon, Mattias
Johansson, Helena
Harvey, Nicholas C.
Liu, Enwu
Vandenput, Liesbeth
Crandall, Carolyn J.
Cauley, Jane A.
LeBoff, Meryl S.
McCloskey, Eugene V.
Kanis, John A.
author_sort Lorentzon, Mattias
collection PubMed
description SUMMARY: In a combined analysis of 25,389 postmenopausal women aged 50–79 years, enrolled in the two Women’s Health Initiative hormone therapy trials, menopausal hormone therapy vs. placebo reduced the risk of fracture regardless of baseline FRAX fracture probability and falls history. INTRODUCTION: The aim of this study was to determine if the anti-fracture efficacy of menopausal hormone therapy (MHT) differed by baseline falls history or fracture risk probability as estimated by FRAX, in a combined analysis of the two Women’s Health Initiative (WHI) hormone therapy trials. METHODS: A total of 25,389 postmenopausal women aged 50–79 years were randomized to receive MHT (n = 12,739) or matching placebo (n = 12,650). At baseline, questionnaires were used to collect information on falls history, within the last 12 months, and clinical risk factors. FRAX 10-year probability of major osteoporotic fracture (MOF) was calculated without BMD. Incident clinical fractures were verified using medical records. An extension of Poisson regression was used to investigate the relationship between treatment and fractures in (1) the whole cohort; (2) those with prior falls; and (3) those without prior falls. The effect of baseline FRAX probability on efficacy was investigated in the whole cohort. RESULTS: Over 4.3 ± 2.1 years (mean ± SD), MHT (vs. placebo) significantly reduced the risk of any clinical fracture (hazard ratio [HR] 0.72 [95% CI, 0.65–0.78]), MOF (HR 0.60 [95% CI, 0.53–0.69]), and hip fracture (0.66 [95% CI, 0.45–0.96]). Treatment was effective in reducing the risk of any clinical fracture, MOF, and hip fracture in women regardless of baseline FRAX MOF probability, with no evidence of an interaction between MHT and FRAX (p > 0.30). Similarly, there was no interaction (p > 0.30) between MHT and prior falls. CONCLUSION: In the combined WHI trials, compared to placebo, MHT reduces fracture risk regardless of FRAX probability and falls history in postmenopausal women. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00198-022-06483-y.
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spelling pubmed-95684352022-10-16 Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials Lorentzon, Mattias Johansson, Helena Harvey, Nicholas C. Liu, Enwu Vandenput, Liesbeth Crandall, Carolyn J. Cauley, Jane A. LeBoff, Meryl S. McCloskey, Eugene V. Kanis, John A. Osteoporos Int Original Article SUMMARY: In a combined analysis of 25,389 postmenopausal women aged 50–79 years, enrolled in the two Women’s Health Initiative hormone therapy trials, menopausal hormone therapy vs. placebo reduced the risk of fracture regardless of baseline FRAX fracture probability and falls history. INTRODUCTION: The aim of this study was to determine if the anti-fracture efficacy of menopausal hormone therapy (MHT) differed by baseline falls history or fracture risk probability as estimated by FRAX, in a combined analysis of the two Women’s Health Initiative (WHI) hormone therapy trials. METHODS: A total of 25,389 postmenopausal women aged 50–79 years were randomized to receive MHT (n = 12,739) or matching placebo (n = 12,650). At baseline, questionnaires were used to collect information on falls history, within the last 12 months, and clinical risk factors. FRAX 10-year probability of major osteoporotic fracture (MOF) was calculated without BMD. Incident clinical fractures were verified using medical records. An extension of Poisson regression was used to investigate the relationship between treatment and fractures in (1) the whole cohort; (2) those with prior falls; and (3) those without prior falls. The effect of baseline FRAX probability on efficacy was investigated in the whole cohort. RESULTS: Over 4.3 ± 2.1 years (mean ± SD), MHT (vs. placebo) significantly reduced the risk of any clinical fracture (hazard ratio [HR] 0.72 [95% CI, 0.65–0.78]), MOF (HR 0.60 [95% CI, 0.53–0.69]), and hip fracture (0.66 [95% CI, 0.45–0.96]). Treatment was effective in reducing the risk of any clinical fracture, MOF, and hip fracture in women regardless of baseline FRAX MOF probability, with no evidence of an interaction between MHT and FRAX (p > 0.30). Similarly, there was no interaction (p > 0.30) between MHT and prior falls. CONCLUSION: In the combined WHI trials, compared to placebo, MHT reduces fracture risk regardless of FRAX probability and falls history in postmenopausal women. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00198-022-06483-y. Springer London 2022-07-14 2022 /pmc/articles/PMC9568435/ /pubmed/35833956 http://dx.doi.org/10.1007/s00198-022-06483-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Article
Lorentzon, Mattias
Johansson, Helena
Harvey, Nicholas C.
Liu, Enwu
Vandenput, Liesbeth
Crandall, Carolyn J.
Cauley, Jane A.
LeBoff, Meryl S.
McCloskey, Eugene V.
Kanis, John A.
Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials
title Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials
title_full Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials
title_fullStr Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials
title_full_unstemmed Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials
title_short Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability—results from the Women’s Health Initiative hormone therapy trials
title_sort menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline frax probability—results from the women’s health initiative hormone therapy trials
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568435/
https://www.ncbi.nlm.nih.gov/pubmed/35833956
http://dx.doi.org/10.1007/s00198-022-06483-y
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