Efficacy of raloxifene for treatment of menopause: a systematic review.
OBJECTIVE
To critically appraise recent randomized controlled trials (RCT) of raloxifene and its effects on the long-term consequences of menopause.


METHODS
All RCTs of greater than six months duration in post-menopausal women found in MEDLINE through July 2000.


CONCLUSIONS
Raloxifene lowered lipids, but estrogen had a more beneficial effect on HDL and fibrinolytic markers. Raloxifene had a more beneficial effect on triglycerides, inflammatory and thrombogenic markers. Compared to placebo, raloxifene reduced vertebral fractures but had a similar although lesser effect on bone mineral density and markers of bone turnover than estrogen. Estrogen receptor positive breast cancer was reduced by 90% with no increase in the incidence of endometrial cancer with raloxifene. The most serious side effect of raloxifene was an increased incidence of deep vein thromboses and pulmonary emboli.


CONCLUSIONS
Raloxifene has been shown to be beneficial using cardiovascular and osteoporosis end-points in studies of short duration. More RCTs of longer duration with comparisons to other traditional treatments are needed before raloxifene becomes the treatment of choice.
Boyack
Mark
M
College of Nursing, Brigham Young University, Provo, UT, USA. sandra_lookinland@byu.edu
Lookinland
Sandra
S
Chasson
Susan
S
D000368:Aged; D015519:Bone Density / Q000187:drug effects; D004717:Endometrium / Q000187:drug effects; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D008055:Lipids / Q000097:blood; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D016896:Treatment Outcome
D008055:Lipids; D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride