The optimal therapy for the prevention and treatment of osteoporosis in primary biliary cirrhosis is unknown.
Hormone replacement therapy prevents osteoporosis, but may promote cholestasis.
Dr Robert Boone and colleagues from Canada assessed transdermal estrogen/progestin in postmenopausal women with primary biliary cirrhosis.
The research team performed a double-blind, randomized, placebo-controlled trial of 31 patients over 24 months.
However, the team reported that trial uptake was limited and treatment arm dropout was significant.
|Placebo-treated patients had a higher percentage loss in femoral neck bone mineral density|
|Digestive Diseases and Sciences|
The team found that placebo-treated patients had a higher percentage loss in femoral neck bone mineral density than actively treated patients.
New fractures occurred in 2 patients on placebo, and in no patients on treatment.
The researchers found that the mean monthly increase in bilirubin was not significantly different between groups.
Individual data suggest that hormone replacement therapy may worsen cholestasis.
Dr Boone's team concludes, “Women with primary biliary cirrhosis have strong feelings about hormone replacement therapy, and recruitment for this intervention is difficult.”
“Transdermal estrogen/progestin likely provides protection against bone loss in primary biliary cirrhosis patients, but may worsen cholestasis. “