Evista - Selected Estrogen Receptor Modulator
Raloxifene
If you have been diagnosed with osteoporosis by your doctor it may be required that you take osteoporosis medications treatments in addition to lifestyle changes in order to combat your condition.
Many people are unable to tolerate oral bisphosphonates such as Fosamax and Actonel, which have many side effects and should not be taken by people with hypocalcemia, renal insufficiency, esophagael irritation, or have undergone recent dental surgery (which has been closely linked with the risk of jaw necrosis). For these people other osteoporosis treatments such as Evista, Forteo, Miacalcin or estrogen treatment are worthy of consideration.
Evista
The selective estrogen receptor molecule raloxifene has been shown to delay the decomposition of bone by blocking cytokine sigalling at the osteoclast. Raloxifene is manufactured as the drug Evista by Eli Lilly. Interestingly raloxifene acts as both an agonist and an antagonist to cytokine sigalling depending on the location in the body, in the breast and uterus it is an antagonist, but at the bone it acts as an agonist with bone estrogen receptors.
Taking Evista - Raloxifene
Raloxifene taken as the drug Evista is usually taken at a dose of 60mg per day to treat postmenopausal osteoporosis. This dose has been demonstrated to both reduce the risk of osteoporosis fractures and increase bone mineral density. It is important not to take Evista if you have venous thromboembolism. Some of the side effects of taking Evista include leg cramps and hot flushes.
Benefits of taking Evista
It has been shown that taking Evista is able to reduce osteoporosis vertebral fractures by as much as 40% one year after the start of treatment. With regards to spinal fractures these may be reduced by 55% in people with no history of spinal fractures and 30% in those with a history of spinal fractures in people who took Evista for a three year period. Although Evista has been shown to be beneficial to vertebral fractures in clinical trials the use of there was no significant correlation between taking the raloxifene drug and a decrease in the risk of getting non-vertebral fractures.
ReferencesEttinger et al (1999). Reduction of vertebral risk in postmenopausal women with osteoporosis treated with raloxifene: Results from a 3-year randomized clinical trial: Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators 637 to 645
Mayes (2007) Review of post menopausal osteoporosis pharmacology. Nutr. Clin. Prac. 22:3: 276 to 285
Mauck and Clarke (2006) Diagnosis, screening, prevention, and of osteoporosis. Clin Proc.:662 to 672