Efficacy of raloxifene for treatment of menopause: a systematic review |
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Authors: | Boyack Mark Lookinland Sandra Chasson Susan |
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Institution: | College of Nursing, Brigham Young University, Provo, UT, USA. sandra_lookinland@byu.edu |
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Abstract: | PURPOSE: To critically appraise recent randomized controlled trials (RCT) of raloxifene and its effects on the long-term consequences of menopause. DATA SOURCES: 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. IMPLICATIONS: 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. |
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Keywords: | Raloxifene Evista therapy for menopause osteoporosis endometrial cancer breast cancer coronary heart disease hot flashes vasomotor instability |
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