TORONTO — Bone mineral density loss in adolescents receiving depot medroxyprogesterone acetate for contraception was substantially or fully reversible following discontinuation of the drug, based on study results.
In girls who lost more than 5% of bone mineral density (BMD) during treatment, complete recovery was less likely, reported Dr. Zeev Harel, professor of pediatrics at Brown University, Providence, R.I.
The study involved 98 healthy adolescents aged 12-18 who initiated depot medroxyprogesterone acetate (DMPA) intramuscular injections for contraception and provided BMD data for up to 300 weeks after cessation of DMPA. BMD was assessed by dual-energy x-ray absorptiometry (DXA).
At the time of DMPA cessation, participants showed mean BMD declines from baseline at the lumbar spine (2.7%), hip (4.1%), and femoral neck (3.9%). Within 60 weeks of DMPA discontinuation, mean BMD values for the lumbar spine had returned to baseline levels. By 240 weeks, they had increased by 4.7% above baseline. Full recovery of mean BMD was not seen until 240 weeks in the hip and 180 weeks in the femoral neck.
Postcessation gains were smaller in girls who exhibited a 5% or greater BMD loss during treatment; mean BMD remained below baseline at 240 weeks (Contraception 2010;81:281-91).
Pfizer funded the study. Dr. Harel has financial ties with Merck & Co., Teva/Duramed, Ortho-McNeil, GlaxoSmithKline, Novartis, and Warner Chilcott.