Pone Rheumatology PLLC

Hormone replacement therapy (HT) ability to reduce bone loss in postmenopausal women is well documented in many papers. HT was traditionally viewed as a standard method of preventing fractures in this population. "When a woman turned 50, that was one of the first things we did - put her on HT," noted Dr. Kogan.

WHI (The Women's Health Initiative hormone therapy) trials in 2002, led to a fair amount of fear and confusion about the use of HT after menopause.
These trials revealed that HT was associated with increased risks of cardiovascular and cerebrovascular events, an increased risk of breast cancer, and other adverse health outcomes.
Even though the WHI studies were the largest randomized trials ever performed in postmenopausal women, they had notable limitations, per Dr. Kogan.
- the average age was 63 years
- they only investigated one route and one dose of estrogen

"Society guidelines are cautious about recommending HT for osteoporosis treatment since estrogen is not approved for treatment, despite the clear fracture protection benefit observed in the WHI study. Since [women in the WHI trials] were not recruited as having osteoporosis, these results do not meet the FDA requirement for treatment approval. However, knowing what we know about the salutary skeletal effects of estrogen, many of us do use them in our patients with osteoporosis - although not prescribed for that purpose." said Dr. McClung. " We have come full circle" said Dr. Kagan.
"If a woman is in early menopause and is having other symptoms, then estrogen is warranted.
If a woman is intolerant to alendronate or other similar drugs, or choses not to have an injectable, then estrogen or a SERM would be an option. There is good scientific data for the use of estrogen," said Dr. Roberts.

Rheumatology News
4/15/22

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413154/

No evidence that chloroquine or hydroxychloroquine induce hemolysis in G6PD deficiency cCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom