Effect of three doses of conjugated estrogens medroxyprogesterone acetate on biomarkers of bone turnover and cartilage degradation in postmenopausal women: The Pan-Asia Menopause (PAM) study

• Published in: Climacteric : the journal of the International Menopause Society Vol. 10; no. 4; pp. 306 - 313
• Main Authors: Ausmanas, M. K., Holinka, C. F., Ling, Y. S., Christiansen, C.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01-08-2007; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adult; Aged; ASIAN WOMEN; Biomarkers - analysis; BONE AND CARTILAGE TURNOVER MARKERS; Bone density; Bone Remodeling - physiology; Cartilage - physiopathology; Collagen - urine; Collagen Type I - urine; Contraceptives, Oral, Synthetic - administration & dosage; Dose-Response Relationship, Drug; Double-Blind Method; EFFICACY; Enzyme-Linked Immunosorbent Assay; Estrogen Replacement Therapy; Estrogens; Estrogens - administration & dosage; Estrogens, Conjugated (USP) - administration & dosage; Female; Gallbladder diseases; HORMONE THERAPY; Humans; Isomerism; Medroxyprogesterone - administration & dosage; Menopause; Middle Aged; Osteocalcin - blood; Peptides - urine; Postmenopause - physiology; Prospective Studies; Womens health
• ISSN: 1369-7137; 1473-0804
• DOI: 10.1080/13697130701463594

Objective To assess the effects of three doses of continuously combined conjugated estrogens (CE) and medroxyprogesterone acetate (MPA) on bone turnover and cartilage degradation markers in early postmenopausal Asian women (mean age 53.6 years).
Methods A total of 1028 women were randomly allocated to receive treatment with either 0.625 2.5, 0.45 1.5, or 0.3 1.5 mg CE MPA for 6 months. End-points were the percent change from baseline in markers of bone resorption (ααCTX, ββCTX), bone formation (osteocalcin), and cartilage degradation (CTX-II).
Results The 0.45 1.5 mg and the 0.625 2.5 mg doses elicited comparable responses as measured by the biomarkers. Women with high rates of bone or cartilage turnover at baseline responded with larger changes to the effects of CE MPA.
Conclusions Lowering the commonly used dose of 0.625 mg CE + 2.5 mg MPA to 0.45 mg CE + 1.5 mg MPA does not significantly alter the inhibitory effect on bone and cartilage turnover in Asian women.