Meta-analysis exploring the effectiveness and safety of different doses of estrogen in the treatment of osteoporosis in perimenopausal women in China

W.-K. Sun, Z.-C. Shao, Q.-P. Yuan

Clinical Medical College, Jiangxi University of Chinese Medicine, Nanchang, China. sunweikang@jxutcm.edu.cn

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• Rheumatology

OBJECTIVE: This study aims to systematically evaluate the effectiveness and safety of using different doses of estrogen in the treatment of perimenopausal osteoporosis in China.

MATERIALS AND METHODS: Computer searches of the Cochrane Library, PubMed, Embase, CBM, CNKI, WanFang Date, and VIP databases were conducted. Randomized Controlled Trials (RCTs) on different doses of estrogen for the treatment of osteoporosis in Chinese perimenopausal women were searched for the period 01/01/2000-06/09/2022. Document screening and data extraction were completed independently by 2 researchers and assessed using the Cochrane recommended risk bias assessment tool for RCTs. The software used for analysis in this study was Stata, version 16.0.

RESULTS: A total of 10 RCTs with a cumulative total of 804 patients were included. Meta-analysis results showed that low doses of estrogen were more effective in improving patient outcomes [OR=0.521, 95% CI (0.300-0.907), z = 2.31, p ≤ 0.05] and bone mineral density [SMD = -0.218, 95% CI (-0.42,-0.016), z = 2.11, p ≤ 0.05] was not superior. For bone metabolism and sex hormone indicators, the standard dose group had a slight advantage, but the difference was small (p > 0.05) and not statistically significant. With regard to safety, the incidence of adverse reactions was higher with the standard dose of estrogen.

CONCLUSIONS: In China, standard doses of estrogen are used for clinical effectiveness. However, vigilance must be maintained for potential safety concerns that may arise during treatment.

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