Journal article
Effect of hormone therapy on risk of hip and knee joint replacement in the Women's Health Initiative
Arthritis and rheumatism, Vol.54(10), pp.3194-3204
2006
DOI: 10.1002/art.22138
PMID: 17009251
Abstract
Objective. To determine the effect of hormone therapy on arthroplasty rates. Methods. We examined data from the Women's Health Initiative placebo-controlled, double-blind, randomized trials. Community-dwelling women ages 50-79 years were enrolled at 40 US clinics. Women with prior arthroplasty were excluded, yielding a sample size of 26,321 subjects. Women who had had hysterectomies (n = 10,272) were randomly assigned to receive 0.625 mg/day conjugated equine estrogens (n = 5,076), or placebo (n = 5,196), with a mean followup of 7.1 years. Those who had not had hysterectomies (n = 16,049) were randomly assigned to receive estrogen plus progestin (n = 8,240), given as 0.625 mg/day conjugated equine estrogens plus 2.5 mg/day medroxyprogesterone acetate, or placebo (n = 7,809), with a mean followup of 5.6 years. Participants reported hospitalizations, and arthroplasties were identified by procedure codes. Arthroplasties due to hip fracture were censored. Cox proportional hazards regression was used to assess hazard ratios (HRs) and 95% confidence intervals (95% CIs) using intent-to-treat methods and outcome of time to first procedure. Results. In the estrogen-alone trial, women receiving hormone therapy had significantly lower rates of any arthroplasty (HR 0.84 [95% CI 0.70-1.00], P = 0.05). However, this effect was borderline statistically significant for hip arthroplasty (HR 0.73 [95% CI 0.52-1.03], P = 0.07), and not significant for knee arthroplasty (HR 0.87 [95% CI 0.71-1.07], P = 0.19). In the estrogen-plus-progestin trial, there was no association for total arthroplasty (HR 0.99 [95% CI 0.82-1.20], P = 0.92) or for individual hip (HR 1.14 [95% CI 0.83-1.57], P = 0.41) or knee (HR 0.91 [95% CI 0.72-1.15], P = 0.41) arthroplasties. Conclusion. These data suggest that hormone therapy may influence joint health, but this observed decrease in risk may be limited to unopposed estrogen and may possibly be more important in hip than in knee osteoarthritis. © 2006, American College of Rheumatology.
Details
- Title: Subtitle
- Effect of hormone therapy on risk of hip and knee joint replacement in the Women's Health Initiative
- Creators
- Dominic J Cirillo - University of IowaRobert B Wallace - University of IowaLIELING WU - Fred Hutch Cancer CenterRobert A Yood - University of Massachusetts Chan Medical School
- Resource Type
- Journal article
- Publication Details
- Arthritis and rheumatism, Vol.54(10), pp.3194-3204
- DOI
- 10.1002/art.22138
- PMID
- 17009251
- NLM abbreviation
- Arthritis Rheum
- ISSN
- 0004-3591
- eISSN
- 1529-0131
- Publisher
- Wiley
- Language
- English
- Date published
- 2006
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984363666402771
Metrics
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