Last update:
28-Dec-2007

OBJECTIVE The aim of this study was to evaluate the effect of tibolone on bone metabolism in late postmenopausal women with decreased bone mineral density (BMD), as estimated by markers of bone remodelling.

METHOD Sixteen women with a mean age of 56.4±4.6 years, mean duration of the postmenopausal period 9.5±5.2 years, and BMD <=1 SD, estimated by quantitative computed tomography (QCT) were assigned to treatment with 2.5 mg tibolone plus 600 mg calcium and 200 U vitamine D daily for 6 months. The control group comprised 11 women matched for age and years after menopause, who received only 600 mg calcium and 200 U vitamine D per day. Markers of bone metabolism were determined at baseline and after the treatment period of 6 months.

RESULTS In the tibolone group there was a significant decrease of serum alkaline phosphatase (P<0.01), deoxypyridinoline (P<0.01), serum phosphate (P<0.01) and urinary calcium excretion (P<0.05), while in the control group these parameters did not show significant changes. No change in the levels of liver enzymes was observed in either group.

CONCLUSIONS Tibolone was found to be effective in suppressing bone remodeling markers in women in late postmenopause with low BMD. The effect on bone resorption markers appears to be expressed earlier and more significantly compared with markers of bone formation. Tibolone was well tolerated and can be used as an alternative to hormone replacement therapy (HRT) in elderly women with low BMD, in which HRT is undesirable.

Key words: Calciuria, DPD, Late postmenopause, Serum AP, Tibolone.