Osteoporotic fracture raloxifene

Since both raloxifene and the non-hormonal drug alendronate reduce the incidence of osteoporotic fractures in postmenopausal women it is relevant to determine which approach is better tolerated and thus most likely to promote long-term adherence to therapy. Adverse effects and compliance have been studied in a direct randomized comparison over 12 months in 902 women attending 154 treatment centres in Spain (21). They took either raloxifene 60 mg/day or alendronate 10 mg/day. Those who took raloxifene reported significantly better compliance than those who took alendronate more patients discontinued alendronate prematurely than raloxifene (26% versus 16%. The main reason for premature discontinuation was adverse reactions, particularly gastrointestinal reactions (9.9% with alendronate, 3.4% with raloxifene). 

National Institute for Health and Clinical Excellence (2008) NICE Technology appraisal 161, Osteoporosis - secondary prevention, including strontium ranelate. Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for secondary prevention of osteoporotic fractures in post menopausal women. Available at http //www.nice.org.uk/Guidance/TA161 [Accessed 18 November 2008],... 

Raloxifene is the only selective oestrogen receptor modulator approved for long-term treatment in the prevention of osteoporotic fractures and for the reduction of invasive breast cancer risk in postmenopausal women. The efficacy and adverse effects of raloxifene as well as its molecular mechanism of action have been recently updated. It is noteworthy that quality-of-life studies demonstrated some favourable effects of raloxifene [32 ]. 

NICE (National Institute for Health and Clinical Excellence) (2005) Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. Available at www.nice.org.uk/nicemedia/pdf/TA087guidance.pdf [Accessed 4 July 2008],... 

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