Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomised trials

BACKGROUND Hormone replacement therapy (HRT) is often seen as the treatment of choice for preventing fractures in women. We undertook a recent meta-analysis of randomised trials which suggested that HRT reduced non-vertebral fractures by 30%. In this analysis we extend that analysis to vertebral fractures. METHODS We searched the main electronic databases until the end of August 2001. We sought all randomised controlled trials (RCTs) of HRT where women had been randomised to at least 12 months of HRT or to no HRT. RESULTS We found 13 RCTs. Overall there was a 33% reduction in vertebral fractures (95% confidence interval (CI) 45% to 98%). CONCLUSIONS This review and meta-analysis showed a significant reduction in vertebral fractures associated with HRT use.