Byung-Koo YoonProfessor Emeritus at Sungkyunkwan University, Republic of Korea
Title: Fracture Recurrence in Hip Fracture with Menopausal Hormone Therapy vs Risedronate: A Clinical Trial
Introduction: The efficacy of menopausal hormone therapy (MHT) on secondary fractures and death in postmenopausal women sustaining hip fracture has been sparsely studied. An open-label, randomized trial was conducted to examine the effects of risedronate therapy versus MHT in postmenopausal Korean women.
Materials and Methods: Among 1,165 women aged 55 years or older with acute, lower-trauma hip fracture, 281 were recruited and randomly assigned to receive oral risedronate (35 mg/week) or percutaneous estradiol gel (1.5 mg/day) plus oral micronized progesterone (100 mg/day) for 4 years. The primary end point was recurrent fracture and the secondary end points were mortality and bone mineral density (BMD).
Results: Seventy-four women (risedronate; 45, MHT; 29) completed the trial (33.2%). Kaplan-Meier analyses showed no significant differences in fracture recurrence and mortality between the two groups. The incidence of any new fracture per 100 person-years (PY) was 8.63 in the risedronate group and 12.86 in the MHT group (P=0.180); that of clinical fracture was 4.75 and 6.99, respectively (P=0.265); that of asymptomatic vertebral fracture was 4.87 and 5.58, respectively (P=0.764). The respective incidence of death per 100 PY was 3.58 and 4.40 (P=0.503). BMD increased comparably at lumbar spine in both groups. BMD at total hip did not change in the risedronate group, but increased significantly by 2.8% at 4 years in the MHT group.
Conclusion: MHT using percutaneous estradiol gel and oral micronized progesterone might not differ from risedronate in the prevention of secondary fractures and death among postmenopausal Korean women with recent hip fractures.
Byung-Koo Yoon has completed his MD at the age of 25 years and PhD at the age of 35 from Seoul National University, Republic of Korea. He is the professor emeritus of Sungkyunkwan University, Republic of Korea. His major area of research was late problems of ovarian hormone deficiency such as osteoporosis, cardiovascular disease, and dementia. He completed six randomized controlled trials with menopausal hormone therapy in Korean women, and served as the presidents of the Korean Society of Menopause (Nov. 2016~Nov. 2018) and the Korean Society for Bone Mineral Research (May 2018~April 2019)