The effect of cessation of raloxifene treatment on bone turnover in postmenopausal women.
There is evidence to suggest accelerated bone loss following estrogen cessation. The effect of cessation of raloxifene therapy on bone turnover is unknown. Our aim was to determine the effect of cessation of raloxifene treatment on bone turnover and bone mineral density (BMD) in postmenopausal, osteopenic women. Women aged 50 to 80 years received raloxifene for 96 weeks and were then randomized to continue raloxifene (group 1, n=20) or placebo (group 2, n=20) for a further 96 weeks. A third group (group 3, n=14) received no treatment. Bone turnover markers and bone density (BMD) were measured throughout the study. Raloxifene treatment for 96 weeks resulted in a decrease in bone turnover (PINP by 31%) and an increase in spine BMD (by 2%) but no change in hip BMD for groups 1 and 2. Continuation of raloxifene (group 1) maintained these changes. Following cessation of raloxifene (group 2), bone markers returned to baseline levels (by 120 weeks). Hip BMD was decreased by 2% at 192 weeks compared to baseline. Bone markers in the controls (group 3) remained at the upper limit of the reference range throughout, with decreases in BMD of 2.3% (spine) and 2.8% (hip). Bone loss following cessation of raloxifene therapy at 96 weeks was greater than in the control group, suggesting accelerated bone loss. The beneficial effect on bone turnover of 96 weeks of raloxifene was lost 6 months after cessation of treatment.
Naylor
K E
KE
University of Sheffield, UK.
Clowes
J A
JA
Finigan
J
J
Paggiosi
M A
MA
Peel
N F A
NF
Eastell
R
R
D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000378:metabolism; D016723:Bone Remodeling / Q000187:drug effects* / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects* / Q000378:metabolism*; D020849:Raloxifene Hydrochloride / Q000008:administration & dosage*; D016896:Treatment Outcome
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D020849:Raloxifene Hydrochloride