Effect of three doses of conjugated estrogens/medroxyprogesterone acetate on biomarkers of bone turnover and cartilage degradation in postmenopausal women: The Pan-Asia Menopause (PAM) study.

OBJECTIVE: To assess the effects of three doses of continuously combined conjugated estrogens (CE) and medroxyprogesterone acetate (MPA) on bone turnover and cartilage degradation markers in early postmenopausal Asian women (mean age 53.6 years).

METHODS: A total of 1028 women were randomly allocated to receive treatment with either 0.625/2.5, 0.45/1.5, or 0.3/1.5 mg CE/MPA for 6 months. End-points were the percent change from baseline in markers of bone resorption (alpha alpha CTX, beta beta CTX), bone formation (osteocalcin), and cartilage degradation (CTX-II).

RESULTS: The 0.45/1.5 mg and the 0.625/2.5 mg doses elicited comparable responses as measured by the biomarkers. Women with high rates of bone or cartilage turnover at baseline responded with larger changes to the effects of CE/MPA.

CONCLUSIONS: Lowering the commonly used dose of 0.625 mg CE + 2.5 mg MPA to 0.45 mg CE + 1.5 mg MPA does not significantly alter the inhibitory effect on bone and cartilage turnover in Asian women.