Long-term effects on bone mineral density and bone metabolism of 6 months’ treatment with gonadotropin-releasing hormone analogues in Japanese women: comparison of buserelin acetate with leuprolide acetate

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Six months of buserelin or leuprolide acetate treatment for endometriosis/uterine fibroids caused temporary decreases in lumbar bone mineral density and increased calcium, with bone density recovering by 1 year post-treatment.

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This study evaluated the effects of 6 months of gonadotropin-releasing hormone analog therapy on lumbar bone mineral density and bone metabolism in 27 Japanese women diagnosed with endometriosis or uterine myoma, followed for an additional year. Bone mineral density at L2–L4 and serum sex steroids and bone turnover markers were measured at baseline, after 6 months, after 12 months, and after 18 months. Lumbar BMD declined during treatment in both groups, with a mean decrease by 6 months of 3.7% for buserelin and 5.1% for leuprolide, and the BMD effect largely resolved by 12 months, while serum calcium rose after 6 months and returned to baseline by 12 months; intact osteocalcin increased after 6 months in the leuprolide group and normalized by 12 months. The authors note that the apparent resolution assumes no additional drugs affecting bone metabolism during follow-up. This paper is centrally about endometriosis — it reports long-term bone mineral density and bone metabolism outcomes of 6-month GnRH analogue treatment in women with endometriosis.

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Abstract

Our objective was to assess the effects of 6 months' treatment with two types of gonadotropin-releasing hormone (GnRH) analogues on lumbar bone mineral density (BMD) and bone metabolism. We studied 27 women who had been given a diagnosis of endometriosis or uterine myoma. The subjects received drug therapy for 6 months and were subsequently followed up for 1 year. The BMD of the lumbar spine (L2, L3, L4) was measured by dual energy X-ray absorptiometry four times: at baseline, after 6 months, after 12 months, and after 18 months. The serum concentrations of sex steroids and bone metabolic markers were measured at the same times as BMD. Compared with the baseline value, the mean decrease in the buserelin group L2-4 BMD was 3.7% at 6 months, 1.7% at 12 months, and 0.4% at 18 months. In the leuprolide group, L2-4 BMD decreased respectively by 5.1%, 6.2%, and 4.3%. Serum concentrations of calcium increased significantly after 6 months of treatment (P < 0.05) and returned to the baseline level at 12 months in both groups. In the leuprolide group, the intact osteocalcin concentration after 6 months was significantly higher than the baseline value, and after 12 months, it decreased to the baseline level. Our results indicate that the effect on BMD of 6 months' treatment with GnRH analogues virtually resolves by 1 year after treatment, provided that drugs affecting bone metabolism are not given during this period.
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Abstract

Our objective was to assess the effects of 6 months’ treatment with two types of gonadotropin-releasing hormone (GnRH) analogues on lumbar bone mineral density (BMD) and bone metabolism. We studied 27 women who had been given a diagnosis of endometriosis or uterine myoma. The subjects received drug therapy for 6 months and were subsequently followed up for 1 year. The BMD of the lumbar spine (L2, L3, L4) was measured by dual energy X-ray absorptiometry four times: at baseline, after 6 months, after 12 months, and after 18 months. The serum concentrations of sex steroids and bone metabolic markers were measured at the same times as BMD. Compared with the baseline value, the mean decrease in the buserelin group L2–4 BMD was 3.7% at 6 months, 1.7% at 12 months, and 0.4% at 18 months. In the leuprolide group, L2–4 BMD decreased respectively by 5.1%, 6.2%, and 4.3%. Serum concentrations of calcium increased significantly after 6 months of treatment (P < 0.05) and returned to the baseline level at 12 months in both groups. In the leuprolide group, the intact osteocalcin concentration after 6 months was significantly higher than the baseline value, and after 12 months, it decreased to the baseline level. Our results indicate that the effect on BMD of 6 months’ treatment with GnRH analogues virtually resolves by 1 year after treatment, provided that drugs affecting bone metabolism are not given during this period. Similar content being viewed by others

References

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Long-term effects on bone mineral density and bone metabolism of 6 months’ treatment with gonadotropin-releasing hormone analogues in Japanese women: comparison of buserelin acetate with leuprolide acetate. J Bone Miner Metab 23, 389–394 (2005). https://doi.org/10.1007/s00774-005-0618-3 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/s00774-005-0618-3

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Condition tags

endometriosis

MeSH descriptors

Bone and Bones Bone Density Buserelin Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Leuprolide Absorptiometry, Photon Adult Bone and Bones Bone and Bones Bone Density Buserelin Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Humans Japan Leuprolide Lumbar Vertebrae

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