Who will benefit from treatment with selective estrogen receptor modulators (SERMs)?
Clinical trials have demonstrated that the selective estrogen receptor modulator raloxifene can reduce the risk of vertebral fracture, but have not unequivocally demonstrated an effect on non-vertebral fracture. Consequently it is recommended that raloxifene be used mainly in postmenopausal women with milder osteoporosis as a preventive measure or for treatment in those with predominantly spinal osteoporosis. Since the effects of raloxifene on bone mineral density and bone turnover may reverse soon after cessation, it is recommended that raloxifene be used as long-term therapy for 5-10 years. Because of its quicker offset, use of raloxifene may have advantages over potent bisphosphonates if use of anabolic agents are contemplated in an individual patient.
Sambrook
Philip
P
Institute of Bone and Joint Research, Building 36, Royal North Shore Hospital, St Leonards, Sydney 2065, Australia.
D000368:Aged; D015519:Bone Density / Q000187:drug effects; D002986:Clinical Trials as Topic; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D011322:Primary Prevention; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*
D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride