HORMONE REPLACEMENT THERAPY PREVENTS BONE LOSS IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE

Patients with inflammatory bowel disease have an increased prevalence of osteoporosis, and suffer high rates of spinal bone loss. Hormone re placement therapy (HRT) is effective in the treatment and prevention o f osteoporosis but has not been studied in patients with inflammatory bowel disease. A two year prospective study of HRT in inflammatory bow el disease was performed in 47 postmenopausal women aged 44 to 67 year s with ulcerative colitis (25) or Crohn's disease (22). Patients had r adial and spinal bone density measured annually by single photon absor ptiometry and quantitative computed tomography respectively. The mean (95% confidence intervals) annual change in radial bone density was +1 .42%/yr (+0.58 to +2-26; p<0.005) and for spinal bone +2-60%/yr (+1.06 to +4.15; p<0.005). There was no significant correlation between rate s of change of bone density at the two sites, or between the rates of change and the initial bone density either in the radius or spine. Twe lve patients were given prednisolone during the study, and their rates of change for spinal bone density were lower, but values were not sta tistically significantly different from those who did not receive cort icosteroids. Changes in bone density for patients with ulcerative coli tis and Crohn's disease were not significantly different. The change i n bone density did not correlate with the patients' age or number of y ears after the menopause. It is concluded that HRT is effective in pre vention of bone loss in postmenopausal women with inflammatory bowel d isease.