Alternative to hormone replacement therapy shows promising results

November 06, 2001

WINSTON-SALEM, N.C. - A study conducted in monkeys has found new evidence that tibolone, a steroid commonly prescribed in Europe as an alternative to hormone replacement therapy, is a promising treatment for osteoporosis and has no adverse artery effects, report scientists from Wake Forest University Baptist Medical Center in this month's Journal of Clinical Endocrinology and Metabolism.

Tibolone is known to increase mineral density, a sign of bone strength, and to alleviate hot flashes and other menopausal symptoms. But doctors have worried that its tendency to reduce high-density lipoprotein, or "good" cholesterol, could result in heart vessel disease. The Wake Forest researchers found that even though tibolone lowered HDL by half, there was no increase in vessel disease. "Our results suggest that tibolone is a cardiovascular-safe treatment for menopausal symptoms as the prevention of osteoporosis," said Thomas Clarkson, D.V.M., professor of comparative medicine at Wake Forest and the study's lead researcher.

The two-year study of 150 postmenopausal monkeys compared two different doses of tribolone, estrogen (Premarin), and estrogen combined with progestin (PremPro). A fifth group of monkeys received no drug treatment. The monkeys received drug doses designed to approximate the levels women are normally prescribed. They were fed a moderately high-fat diet (42 percent of calories from fat) designed to speed up the development of vessel disease.

"We found that both Premarin and PremPro had a robust cardiovascular protective effect, but there was no such protective effect from tibolone," said Clarkson. "On the other hand, we found that tibolone may have advantages over Premarin and PremPro for breast and uterine safety."

Bone mineral density increased by 9.5 percent in the group receiving the high dose of tibolone, 4.5 percent in the PremPro group, and 4.3 percent in the Premarin group. PremPro and Premarin both reduced coronary atherosclerosis by 62 percent, while tiboline had no effect.

The Premarin and PremPro groups both had increased cell growth in the breasts and uterus, which can relate to cancer risk. "Women who are considering treatment for osteoporosis and menopausal symptoms have several options and must work with their doctors to weigh the benefits versus the risks of each," said Clarkson. "Our study is significant because it adds to the current knowledge about these choices."

Tibolone, which is considered an alternative to hormone replacement therapy for women concerned about breast cancer, is approved in 19 European countries for treating postmenopausal symptoms and preventing osteoporosis. It is under consideration by the U.S. Food and Drug Administration for approval.
-end-
Media Contacts: Karen Richardson, (336) 716-4453, krchrdsn@wfubmc.edu

Wake Forest Baptist Medical Center

Related Osteoporosis Articles from Brightsurf:

New opportunities for detecting osteoporosis
Osteoporosis can be detected through low dose computed tomography (LDCT) imaging tests performed for lung cancer screening or other purposes.

Oxytocin can help prevent osteoporosis
In a laboratory experiment with rats, Brazilian researchers succeeded in reversing natural processes associated with aging that lead to loss of bone density and strength.

New strategy against osteoporosis
An international research team has found a new approach that may be able to reduce bone loss in osteoporosis and maintain bone health.

New review on management of osteoporosis in premenopausal women
An IOF and ECTS Working Group have published an updated review of literature published after 2017 on premenopausal osteoporosis.

Cardiac CT can double as osteoporosis test
Cardiac CT exams performed to assess heart health also provide an effective way to screen for osteoporosis, potentially speeding treatment to the previously undiagnosed, according to a new study.

Osteoporosis treatment may also protect against pneumonia
A recent study published in the Journal of Bone and Mineral Research found that nitrogen-containing bisphosphonates (N-BPs) such as alendronate, which are widely used to treat postmenopausal osteoporosis, are linked with lower risks of pneumonia and of dying from pneumonia.

New pharmaceutical target reverses osteoporosis in mice
Biomedical engineers at Duke University have discovered that an adenosine receptor called A2B can be pharmaceutically activated to reverse bone degradation caused by osteoporosis in mouse models of the disease.

A link between mitochondrial damage and osteoporosis
In healthy people, a tightly controlled process balances out the activity of osteoblasts, which build bone, and osteoclasts, which break it down.

Many stroke patients not screened for osteoporosis, despite known risks
Many stroke survivors have an increased risk of osteoporosis, falls or breaks when compared to healthy people.

Many postmenopausal women do not receive treatment for osteoporosis
The benefits of treating osteoporosis in postmenopausal women outweigh the perceived risks, according to a Clinical Practice Guideline issued today by the Endocrine Society.

Read More: Osteoporosis News and Osteoporosis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.