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Dosis ultrabaja de 17beta-estradiol micronizado y densidad ósea y metabolismo óseo en mujeres mayores: un ensayo
Karen M Prestwood1, Anne M Kenny, Alison Kleppinger
1Center on Aging, University of Connecticut Health Center, Farmington 06030, USA. Prestwood@nso1.uchc.edu
JAMA
|August 28, 2003
Resumen
La terapia de estrógenos en dosis bajas (0,25 mg/día de 17beta-estradiol) aumentó efectivamente la densidad mineral ósea y redujo la rotación ósea en mujeres posmenopáusicas mayores sanas durante tres años. Este tratamiento mostró efectos adversos mínimos, lo que sugiere una opción segura y efectiva para la prevención de la osteoporosis.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Gerontología Gerontología.
- Metabolismo óseo Metabolismo óseo.
Sus antecedentes:
- La terapia con estrógenos es reconocida para la prevención de la osteoporosis.
- Las dosis convencionales están vinculadas a eventos adversos.
- La eficacia de las dosis bajas de estrógeno (0,25 mg/día) para prevenir la pérdida ósea sigue sin estar establecida.
Objetivo del estudio:
- Evaluar el impacto de 0,25 mg/d de 17beta-estradiol micronizado en la densidad mineral ósea (DMO) y la rotación ósea.
- Para evaluar estos efectos durante un período de tratamiento de 3 años en mujeres posmenopáusicas sanas y mayores.
Principales métodos:
- Un ensayo aleatorizado, doble ciego y controlado con placebo de 3 años.
- En ella participaron 167 mujeres sanas mayores de 65 años.
- BMD medido anualmente; marcadores bioquímicos evaluados de la rotación ósea y los niveles hormonales al inicio, 3 meses y años 1 y 3.
Principales resultados:
- Las dosis bajas de estrógeno aumentaron significativamente la DMO en la cadera, la columna vertebral y el cuerpo total en comparación con el placebo (P<.001).
- Los marcadores de rotación ósea (N-telopéptidos, fosfatasa alcalina ósea) disminuyeron significativamente con dosis bajas de estrógeno (P<.001).
- Los perfiles de eventos adversos fueron similares entre los grupos, sin diferencias significativas en la sensibilidad mamaria, cambios endometriales o resultados mamográficos.
Conclusiones:
- La dosis baja de 17beta-estradiol (0,25 mg/día) aumenta efectivamente la densidad ósea y reduce la rotación ósea en mujeres mayores.
- El tratamiento demostró un perfil de seguridad favorable con efectos adversos mínimos.
- Se necesita más investigación para investigar el efecto de la dosis baja de estrógeno en la prevención de fracturas.
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