Placebokontrollierte, randomisierte Doppelblindstudie zum Einfluss einer kombiniert-kontinuierlichen, transdermalen Hormonersatztherapie im Vergleich zur kombinierten Therapie mit Natriummonofluorphosphat und kombiniert-kontinuierlichen, transdermalen Hormonersatztherapie im Vergleich zu Placebo auf die Knochendichte (DXA) sowie die Quantitative Ultrasonometrie (QUS)

Osteoporosis, then as now, is considered an important and underdiagnosed common disease that requires a large-scale treatment approach. It mainly affects postmenopausal women, due to a physiological cessation of estrogen production by the ovaries. The preventive treatment of postmenopausal osteoporosis with the help of hormone therapies has already been sufficiently proven in numerous high-quality studies. Administration of hormone replacement therapies with estrogens and progestins can significantly reduce the risk of fracture in postmenopausal women even without an increased risk of fracture. Also in the current S3 guideline of the “Dachverband für Osteologie” the treatment of osteoporosis by hormone replacement therapy is a very effective therapeutic option, even though it may only be administered after a detailed cost-benefit analysis. First-line hormone therapy is envisaged by the organization only in cases of existing menopausal symptoms or as a case-by-case decision (DVO 2017, NICE guidelines 2015). For a long time, it was believed that additional therapy with fluorides in a combination with HRT showed a further, effectiveness-increasing, approach. This work also looked more closely at this therapeutic option and attempted to prove the efficacy of fluorides through a placebo-controlled, randomized, double-blind trial. As mentioned above, the desired effect could not be shown. And it remains questionable whether further scientific work in this direction can be expected. The current therapeutic options for osteoporosis must be subdivided into basic measures, such as diet, renunciation of nicotine as well as sufficient exercise, etc., and in addition, of course, the medicinal therapies for osteoporosis. A subdivision can be made into three pillars, which represent the mode of action of the various groups of drugs. 1. antiresorptive (e.g. bisphosphonates, denosumab, estrogens) 2. dual mode of action (e.g. Romosozumab) 3. osteoanabolic (e.g. teriparatide) According to the current guideline of the organization for osteology (Dachverband für Osteologie), all of the above-mentioned drugs represent possible therapy options and it should be considered individually which drug should be given for which duration.