Co můžeme očekávat od raloxifenu přiléčbě postmenopauzální osteoporózy – pohledgynekologa

What Can We Expect from Raloxifene in the Treatmentof Postmenopausal Osteoporosis: Gynaecological Pointof View

Objective:
Evaluation of positive properties and side effects of raloxifene treatment with respectto its potential use as agent to improve women’s health and quality of life in postmenopausalyears.Design: A review article.Setting: Obstetrics and Gynaecology Department, Charles University 2nd Medical Faculty andTeaching Hospital Motol, Prague.Subject: Estrogen use may protect against osteoporosis and cardiovascular disease, but may increasethe risk of breast cancer in long-term treated women and also may increase the risk ofirregular uterine bleeding (in combination with gestagen in non-hysterectomized women) in perimenopauseand postmenopause. Drugs with tissue-specific estrogenic effects are termed selectiveestrogen receptor modulators (SERM). Tamoxifen is the first SERM successfully used in the preventionand treatment of breast cancer. Another SERM raloxifene is widely used in the preventionand treatment of postmenopausal osteoporosis, especially in women without climactericcomplaints. Therapy with raloxifene increases bone mineral density, lowers serum concentrationsof total and low-density lipoprotein cholesterol, and does not stimulate endometrium andbreast. Evaluation of another potential positive effects (reducing size of uterine leiomyomas, etc.)warrants further investigation.Conclusion: Raloxifene can be used in postmenopausal women free of climacteric symptoms forthe prevention and treatment of postmenopausal osteoporosis with no increased risk of thrombosisand with the advantage of positive side effects during the treatment.

Key words:
raloxifene, SERM, osteoporosis, endometrial cancer, breast cancer, postmenopause,cardiovascular disease