Appendix C6Evidence Table of Trials Reporting Incidence of Fractures

Author, year; titlePopulationResults (Treatment vs. Placebo)
Fracture incidence
Cauley, 2003;24 Effects of estrogen plus progestin on risk of fracture and bone mineral density.
WHI Estrogen plus progestin trial
Women enrolled in WHI trial:
8,506 Estrogen plus progestin
8,102 Placebo
Hip
52 vs. 73; HR, 0.67 (95% CI, 0.47 to 0.96)
No significant interactions with age, years since menopause, BMI, smoking, number of recent falls, parental history of fracture, previous HT, history of fracture, or fracture risk score; improved effect with calcium intake >1200 mg/d.
Total
733 vs. 896; HR, 0.76 (95% CI, 0.69 to 0.83)
No significant interactions with age, years since menopause, BMI, smoking, number of recent falls, total calcium intake, parental history of fracture, previous HT, race or ethnicity, history of fracture, fracture risk score, or low baseline BMD.
Rossouw, 2002;12 Risks and benefits of estrogen plus progestin in healthy postmenopausal women.
WHI Estrogen plus progestin trial
Women enrolled in WHI trial:
8,506 Estrogen plus progestin
8,102 Placebo
Hip
44 vs. 62; HR, 0.66 (95% CI, 0.45 to 0.98)
Vertebral
41 vs. 60; HR, 0.66 (95% CI, 0.44 to 0.98)
Other osteoporotic
579 vs. 701; HR, 0.77 (95% CI, 0.69 to 0.86)
Total
650 vs. 788; HR, 0.76 (95% CI, 0.69 to 0.85)
LaCroix, 2011;49 Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy post-intervention.
WHI Estrogen only trial
Women enrolled in WHI trial:
5,310 Estrogen
5,429 Placebo
Hip intervention
48 vs. 74; HR, 0.67 (95% CI, 0.46 to 0.96)
Hip postintervention
66 vs. 53; HR, 1.27 (95% CI, 0.88 to 1.82)
Hip overall
114 vs. 127; HR, 0.92 (95% CI, 0.71 to 1.18)
Anderson, 2004;42 Effects of conjugated equine estrogen in postmenopausal women with hysterectomy.
WHI Estrogen only trial
Women enrolled in WHI trial:
5,310 Estrogen
5,429 Placebo
Hip
38 vs. 64; HR, 0.61 (95% CI, 0.41 to 0.91)
Vertebral
39 vs. 64; HR, 0.62 (95% CI, 0.42 to 0.93)
Total
503 vs. 724; HR, 0.70 (95% CI, 0.63 to 0.79)
No significant interactions with age.
Hulley, 2002;61 Noncardiovascular disease outcomes during 6.8 years of hormone therapy (Heart and Estrogen/Progestin Replacement Study follow-up, HERS II).
HERS II Estrogen plus progestin trial
Women from original HERS trial who consented to followup:
2,321
Hip
40 vs. 25; HR, 1.61 (95% CI, 0.98 to 2.66)
Wrist
42 vs. 43; HR, 0.98 (95% CI, 0.64 to 1.50)
Vertebral
26 vs. 30; HR, 0.87 (95% CI, 0.52 to 1.48)
Other
144 vs. 154; HR, 0.94 (95% CI, 0.75 to 1.18)
Any
230 vs. 222; HR, 1.04 (95% CI, 0.87 to 1.25)

Abbreviations: BMD=bone mineral density; BMI=body mass index; CI=confidence interval; HERS=Heart and Estrogen/Progestin Replacement Study; HR=hazard ratio; HT=hormone therapy; WHI=Women’s Health Initiative.

From: Appendix C, Evidence and Quality Tables

Cover of Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions
Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: Systematic Review to Update the 2002 and 2005 U.S. Preventive Services Task Force Recommendations.
Evidence Syntheses, No. 93.
Nelson HD, Walker M, Zakher B, et al.

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