Researchers compare drugs used to prevent osteoporosis

Main Category: Cholesterol
Article Date: 27 Apr 2004 - 0:00 PDT


Raloxifene, a drug used to prevent osteoporosis in postmenopausal women, and conjugated equine estrogen (CEE, a hormone therapy) help increase bone density, although CEE seems to be more effective, according to an article in the April 26 issue of The Archives of Internal Medicine, one of the JAMA/Archives journals.

According to information in the article, raloxifene helps prevent bone loss and increases bone mineral density, and CEE has also been used to help prevent osteoporosis. However, there is little information comparing the two drugs.

Ian R. Reid, M.D., of The University of Auckland, New Zealand, and colleagues compared the effects of CEE and different dosages of raloxifene on bone mineral density in 619 postmenopausal women (average age, 53 years) with prior hysterectomy at 38 medical centers in Europe, North America, Australasia and South Africa.

In this randomized, placebo-controlled trial, women were randomly assigned to take either 60 milligrams per day of raloxifene, 150 milligrams per day of raloxifene, 0.625 milligrams per day of CEE, or placebo. Bone mineral density was measured in the spine and in the femur (a large bone in the leg). The study lasted three years.

The researchers found that bone density declined by two percent in the placebo group, was stable in the two raloxifene groups, and increased by 4.6 percent in the CEE group. At three years, total cholesterol levels were not different compared to the beginning of the study for the placebo group and the CEE group, however, triglyceride concentrations (certain types of fats in the blood) increased by 24.6 percent in the CEE group at three years, a significantly greater change than in the raloxifene groups, which were 4.9 percent and 8.0 percent above levels at the beginning of the study.

The researchers also found that raloxifene did not affect high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), but CEE increased it by 13.4 percent compared with placebo.

"Raloxifene and CEE have beneficial effects on bone density and bone turnover, although effects of CEE are more marked," write the researchers.

"This is one of few studies to directly compare the effects of treatments widely used in the management of osteoporosis. Its findings are broadly consistent with previous data relating to raloxifene, other selective estrogen receptor modulators, and estrogen. Modest changes in bone turnover markers have been reported with raloxifene, whereas those associated with the use of estrogen have tended to be larger, as found in the present study."

(Arch Intern Med. 2004;164:871-879. Available post-embargo at archinternmed.com)

Editor's Note: This study was supported by a grant from Lilly Research Laboratories.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

To contact Ian R. Reid. M.D., e-mail i.reid@auckland.ac.nz.

Contact: Ian R. Reid, M.D.
i.reid@auckland.ac.nz
JAMA and Archives Journals Website

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