Fractures tibolone

A 2-year randomized controlled study in 90 women compared the effects of oral tibolone doses of 1.25 mg/day and 2.5 mg/day on bone loss in the early postmenopausal period all took calcium 1000 mg/day. Vertebral and femoral bone density rose in both treated groups but fell in the control group, and bone turnover markers (urinary excretion of hydroxyproline/creatinine and plasma osteocalcin concentrations) were similarly affected favorably in the treated groups, as was the incidence of hot flushes/ flashes (5). Studies such as this still leave open the question of the advisability of continuing tibolone treatment over a longer period. While tibolone has indeed been shown to benefit mineral bone density, few data are available to show whether it lowers fracture incidence nor is it clear whether there is a link between tibolone and breast cancer (6). 

Tibolone has combined estrogenic, progestogenic, and androgenic activity. Its effects depend on metabolism and activation in peripheral tissues. Tibolone has beneficial effects on mood and hbido and improves menopausal symptoms and vaginal atrophy. It protects against bone loss and reduces the risk of vertebral fractures. It reduces total cholesterol, triglyceride, lipoprotein (a), and, unfortunately, high-density lipoprotein concentrations. It may increase cardiovascular risk, breast cancer risk, and endometrial cancer risk. 

Tibolone can prevent bone loss in early postmenopausal women. A placebo-controlled study investigating the effects of tibolone on fractures is currently ongoing. 

Tibolone 1.25 mg or 2.5 mg/day Tibolone prevents bone loss. No data are yet available regarding fracture rates. 

Tibolone (Livial) is widely used in treatment of vasomotor symptoms and prevention of osteoporosis. The parent compound itself is devoid of activity, but it is metabolized in a tissue-selective manner to three metabolites that have predominantly estrogenic, progestogenic, and androgenic activities. The drug appears to increase bone mineral density and decrease vasomotor symptoms without stimulating the endometrium, but its effects on fractures, breast cancer, and long-term outcomes remain to be established. 

Cardiovascular In some cases tibolone prevents bone loss in elderly subjects, although after 40 years of use some questions regarding its clinical role remain unanswered. In a randomized study in the US, in which 4538 older women took either tibolone 1.25 mg/day or placebo, tibolone reduced the risk of vertebral fractures and of breast cancer. However, there was an increased risk of stroke (relative hazard = 2.19 95% Cl = 1.14, 4.23) the study was stopped after a mean treatment period of 34 months at the recommendation of the data and safety monitoring board [83. There were no significant differences between the two groups in the risks of either coronary heart disease or venous thromboembolism. 

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