The Effects of Nafarelin and Danazol on Vertebral Trabecular Bone Mass in Patients With Endometriosis

Whitehouse, Richard W.; Adams, Judith E.; Bancroft, K.; Vaughan-Williams, C. A.; Elstein, Max

doi:10.1111/j.1365-2265.1990.tb00501.x

Cited by 62 publications

(24 citation statements)

References 19 publications

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“…Circulating estradiol levels decrease to the post-menopausal range, producing important menopausal side effects, such as a reduction in BMD at the lumbar spine2829 and proximal femur 30. Therefore, there is a need for the prevention of bone loss during long term treatment with GnRH-a.…”

Section: Discussionmentioning

confidence: 99%

Raloxifene Administration in Women Treated with Long Term Gonadotropin-releasing Hormone Agonist for Severe Endometriosis: Effects on Bone Mineral Density

Cho¹,

Kim

et al. 2016

J Menopausal Med

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ObjectivesTo evaluate the efficacy of raloxifene in preventing bone loss associated with long term gonadotropin-releasing hormone agonist (GnRH-a) administration.MethodsTwenty-two premenopausal women with severe endometriosis were treated with leuprolide acetate depot at a dosage of 3.75 mg/4 weeks, for 48 weeks. Bone mineral density (BMD) was evaluated at admission, and after 12 treatment cycles.Results At cycle 12 of GnRH-a plus raloxifene treatment, lumbar spine, trochanter femoral neck, and Ward's BMD differed from before the treatment. A year after treatment, the lumbar spine and trochanter decreased slightly, but were not significantly different.ConclusionsOur study shows that the administration of GnRH-a plus raloxifene in pre-menopausal women with severe endometriosis, is an effective long-term treatment to prevent bone loss.

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Section: Discussionmentioning

confidence: 99%

Raloxifene Administration in Women Treated with Long Term Gonadotropin-releasing Hormone Agonist for Severe Endometriosis: Effects on Bone Mineral Density

Cho¹,

Kim

et al. 2016

J Menopausal Med

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“…Mean trabecular BMD was measured in mg cc of mineral equivalents of either K 2 HPO 4 in water (n = 4) or calcium hydroxyapatite (n = 28). Precision (CV%) of the technique in our department is 1% in normal subjects and 2.5% in osteoporotic patients (Adams and Adams, 1988;Whitehouse et al, 1990). …”

Section: Quantitative Computed Tomography (Qct)mentioning

confidence: 97%

Reduced bone mineral density in young adults following cure of acute lympblastic leukaemia in childhood

et al. 1999

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Bone mineral density (BMD), serum osteocalcin and type I collagen C-telopeptide (ICTP) were assessed in a cohort of 31 (16 males) adults who had received cranial irradiation in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL). Markers of bone turnover were compared with those of 35 age and body mass index (BMI) matched young adults (18 male). Growth hormone status had previously been determined using an insulin tolerance test and arginine stimulation test. Eight patients were classified as severe growth hormone deficiency (group 1), 12 patients as growth hormone insufficient (group 2) and 11 patients as normal (group 3). Vertebral trabecular BMD, lumbar spine and femoral neck integral BMD and forearm cortical bone mineral content (BMC) was measured 17.8 (6.8–28.6) years after cranial irradiation and was expressed as Z (standard deviation) scores. There was a significant reduction in vertebral trabecular BMD (median Z score –1.25, P < 0.001), in lumbar spine integral BMD (median Z score –0.74, P = 0.001), in forearm cortical BMC (median Z score –1.35, P < 0.001), and less so in femoral neck integral BMD (median Z score –0.43, P = 0.03). There was no difference among the growth hormone status groups for the following BMD measurements: vertebral trabecular BMD, lumbar spine integral BMD or femoral neck integral BMD ( P = 0.8, P = 0.96 and P = 0.4 respectively). There was only a marginal significant difference for BMD at the wrist between growth hormone status groups ( P = 0.04). There was no correlation between the BMD measurements with time since or age at diagnosis and no difference in markers of bone turnover between patients and controls; median serum osteocalcin 13.3 and 12.0 ng ml ( P = 0.7), respectively, and for ICTP 5.0 and 4.9 μg L ( P = 0.67) respectively. In conclusion, there is a highly significant reduction in BMD in young adults following treatment for ALL in childhood. The reduction in BMD affects both trabecular and cortical bone but did not seem to be related to time since diagnosis, age at diagnosis, or current growth hormone status. Possible explanations include a direct effect of chemotherapy, steroids or both on bone during childhood and hence an effect on the accretion of bone mass. In view of the risk of fractures in patients with osteopenia, adults treated for ALL in childhood may be at an increased risk of bone fractures later in life irrespective of the underlying cause of the osteopenia and thus intervention should be considered. © 1999 Cancer Research Campaign

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“…The degree of this is dependent upon the site studied and the technique of measurement. The degree of bone‐mineral loss is, however, unlikely to be of clinical relevance and appears to be reversible with the return of ovarian function 19–21 . Bone loss may, however, have implications in terms of long‐term therapy and would make it unwise to administer repeat doses of therapy in close approximation.…”

Section: Metabolic Side‐effects: Safety Issuesmentioning

confidence: 99%

The role of GnRH analogues in the treatment of endometriosis

Shaw

1992

BJOG

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The Effects of Nafarelin and Danazol on Vertebral Trabecular Bone Mass in Patients With Endometriosis

Cited by 62 publications

References 19 publications

Raloxifene Administration in Women Treated with Long Term Gonadotropin-releasing Hormone Agonist for Severe Endometriosis: Effects on Bone Mineral Density

Raloxifene Administration in Women Treated with Long Term Gonadotropin-releasing Hormone Agonist for Severe Endometriosis: Effects on Bone Mineral Density

Reduced bone mineral density in young adults following cure of acute lympblastic leukaemia in childhood

The role of GnRH analogues in the treatment of endometriosis

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