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1.
[Diagnostic imaging of treatment in osteoporosis: SERM].
Takada, J, Iba, K, Yamashita, T
Clinical calcium. 2011;(7):1047-55
Abstract
The effectiveness of selective estrogen receptor modulator (SERM) in X-ray, dual X-ray Absorptiometry (DXA), quantitative computed tomography (QCT), and hip structure analysis (HSA) are reviewed. Raloxifene and bazedoxifene increase bone mineral density in the spine and femoral neck, and reduce risk of vertebral fracture in women with osteoporosis, and reduce risk of nonvertebral fractures in women with higher fracture risk. Raloxifene improved bone density and micro architecture in spine and limbs (distal radius and distal tibia) represented by volumetric QCT and high-resolution peripheral QCT. Raloxifene also improved HSA parameters in femoral neck, intertrochanter, and shaft regions. The tendency to change in these parameters is approximately similar in raloxifene and bisphosphonates (alendronate, risedronate, minodronate). These results indicate that raloxifene improved the bone density and bone quality in spine, limbs and hip.
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2.
[Effects of SERMs on bone health. Combination therapy with raloxifene].
Gorai, I, Hori, H
Clinical calcium. 2010;(3):408-12
Abstract
It is generally considered that drugs with different pharmacological actions are prescribed when combination therapy is undertaken. Vitamin D insufficiency or deficiency is prevalent in osteopenic and osteoporotic postmenopausal women. Combination therapy of raloxifene with other agents including vitamin D has been reported and its effect on fracture prevention remains to be elucidated.
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3.
[Effects of SERMs on bone health. SERM actions other than on the bones. With special reference to the actions of SERM on the skin and vascular elasticity].
Sumino, H, Ichikawa, S
Clinical calcium. 2010;(3):388-94
Abstract
Raloxifene, a selective estrogen receptor modulator (SERM), was developed with the aim of preventing and treating postmenopausal osteoporosis. Raloxifene is frequently compared to estrogen preparations, and it is considered that besides its actions on the bone, raloxifene also has actions on the skin and vascular elasticity in a way similar to estrogen preparations. Some reports have recently shown improvement of the skin elasticity following administration of raloxifene or transdermal and oral administration of estrogen preparations. Arterial elasticity has been reported to be improved by transdermal administration of an estrogen preparation, but not by raloxifene. However, there have been very few reports on these actions of raloxifene, and many points remain unclear concerning the effects of this drug class in the present clinical situation. Future studies are expected to clarify the actions of SERM other than on the bones, and also reveal the action mechanisms of drugs belonging to this class.
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4.
[Effects of SERMs on bone health. Efficacy of SERM for incidence of fractures in osteoporotic patients with lifestyle-related diseases].
Sakai, A, Nakamura, T
Clinical calcium. 2010;(3):322-9
Abstract
Osteoporosis is closely associated with lifestyle-related diseases, such as diabetes mellitus, hypertension, and hyperlipidemia. The meta-analysis data reveals that risk of hip fracture is higher in the patients with diabetes mellitus or hypertension compared with those without it. Bone quality more markedly contributes to bone strength in osteoporosis associated with diabetes mellitus than without it. The reduction rate of vertebral fractures by raloxifene in the osteoporotic women with diabetes mellitus is higher than or equal to those without it. Raloxifene more markedly reduces vertebral fractures in the osteoporotic women with high value of serum triglyceride. Raloxifene improves hyperlipidemia in the postmenopausal osteoporotic women and increases the value of serum adiponection in the postmenopausal osteoporotic women without diabetes mellitus.
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5.
[Combination therapy for osteoporosis].
Kishimoto, H
Nihon rinsho. Japanese journal of clinical medicine. 2009;(5):975-9
Abstract
Combination therapy of the two agents for osteoporosis has not been determined to be more effective or not than the use of either one alone. Bisphosphonates are now the most widely used drugs for osteoporosis. Concurrent administration of bisphosphonate and vitamin D could increase bone mineral density (BMD) more than the use of bisphosphonate alone especially in the patients with vitamin D deficiency. Bisphosphonates increased BMD, but the increment of BMD was reached to plateau after two or three years. After stopping bisphosphonates, PTH administration was effective to gain more BMD. Sequential administration of antiresorber (bisphosphonate or raloxifene) and PTH could be more effective than the use of bisphosphonate alone. But there would be some differential effects of sequential treatment on BMD among antiresorbers. Longer-term studies of fractures are needed to determine whether and how antiresorptive drugs can be optimally used in conjunction with parathyroid hormone therapy. Further studies are necessary to fully ascertain the clinical significance of combination therapy in postmenopausal osteoporosis.
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6.
[Drug selection guide for osteoporosis determined by the clinical staging, pathophysiology and age].
Tanaka, I, Oshima, H
Nihon rinsho. Japanese journal of clinical medicine. 2009;(5):915-20
Abstract
The various therapeutic agents for osteoporosis became currently available and it is significant to select drugs according to disease stage, pathophysiology and age. As markers for bone resorption and bone mineral density can predict the subsequent risk of hip fracture in elderly women, bone resorption inhibitors such as bisphosphonate or raloxifene are appropriate for subjects with high levels of the marker or low bone mineral density. Moreover, bisphosphonate and raloxifene are also recommended for subjects with prevalent fractures, even though disease staging in osteoporosis is complicated. However, these data should be carefully referred in clinical application, since they were obtained in combination with vitamin D and calcium preparation.
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7.
[Muscle and bone health as a risk factor of fall among the elderly. Role of raloxifene in the prevention of osteoporotic fractures].
Ohta, H
Clinical calcium. 2008;(6):828-35
Abstract
Accumulated evidence has clearly shown that the objective of osteoporosis lies in the prevention of osteoporotic fractures. This has led in recent years to therapeutic agents with prophylactic effects against osteoporotic fractures becoming widely used in the clinical setting as first-line agents for the treatment of osteoporosis. In this review, we provide an overview of the evidence accumulated to data on the effect of raloxifene in the prophylaxis of osteoporotic fractures. At present, evidence that supports the use of raloxifene for prophylaxis of non-vertebral fractures remains rather inadequate compared to that supports the use of bisphosphonates. However, there is mounting evidence that suggests the role of raloxifene in maintaining and improving bone structure, where raloxifene is shown to enhance bone strength by improving bone quality, suggesting its potential role in preventing non-vertebral fractures as well as in vertebral fractures.
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8.
[Evidence for the selective estrogen receptor modulator raloxifene: its evolving role in the treatment of osteoporosis].
Ohta, H
Clinical calcium. 2008;(10):1442-50
Abstract
Several lines of evidence demonstrate that the objective of osteoporosis treatment consists in the prophylaxis of osteoporotic fractures. With the endpoint of osteoporosis treatment thus clarified, currently, the selective estrogen receptor modulator (SERM) raloxifine represents the mainstay of therapy for osteoporosis, together with the antiresorptive agents bisphosphonates. Thus, this review has drawn mainly on the results of the MORE study to explore the efficacy of raloxifene in inhibiting bone metabolism, increasing bone mineral density effects, and preventing bone fractures. Notably, the available evidence for raloxifene suggests that the efficacy of raloxifene in preventing bone fractures has not only to do with bone mineral density but also to do with bone quality.
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9.
[Hormone replacement Up-to-date. Selective estrogen receptor modulator (SERM) for the treatment of osteoporosis].
Hosoi, T
Clinical calcium. 2007;(9):1419-23
Abstract
Raloxifen is a selective estrogen receptor modulator (SERM) which is used for the treatment of osteoporosis. The major mechanism of action is the suppression of bone resorption. Evidences for the increase of bone mineral density and the decrease of vertebral fractures have been confirmed, while the effects on non-vertebral fractures may need more evidences. There is no doubt for that this drug is one of the major medicines for osteoporosis. On the other hand, extra-skeletal effects including those on cardiovascular systems should be studied further.
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10.
Primary prevention of breast cancer: new approaches.
Cummings, SR
Maturitas. 2007;(1):39-41
Abstract
Lifestyle changes, such as exercise, might reduce the risk of breast cancer. Tamoxifen and raloxifene reduce the risk of breast cancer but have potential adverse effects and, therefore, should be considered by women at high risk of breast cancer. Breast density is a strong risk factor for breast cancer; assessment of breast density can be combined with risk factors to estimate a woman's risk of breast cancer. I propose that a woman's risk of breast cancer be assessed along with her screening mammogram with consideration of chemoprevention for those at high risk.