Rheumatology

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Baseline serum estradiol and fracture reduction during treatment with hormone therapy: The Womens Health Initiative randomized trial
Osteoporosis International, 05/19/09

Cauley JA et al. – Study demonstrates that the effect of hormone therapy (HT) on fracture reduction is independent of estradiol and sex hormone binding globulin (SHBG) levels.

• Aim was to test the hypothesis that the reduction in fractures with HT is greater in women with lower estradiol (E2) levels
• A nested case–control study within the Women's Health Initiative HT Trials
• 231 hip fracture case–control pairs and a random sample of 519 all fracture case–control pairs
• Cases and controls matched for age, ethnicity, randomization date, fracture history, and hysterectomy status
• Hormones were measured prior to randomization
• Incident cases of fracture were identified over an average f/u of 6.53 yrs

• No evidence that the effect of HT on fracture differed by baseline E2 or SHBG
• Across all quartiles of E2 and SHBG, women randomized to HT had about a 50% lower risk of fracture, including hip fracture, vs placebo

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