Clin Osteol 2003; 8(3): 86-88
Monitoring of bone changes in women treating with raloxifeneArticles
Raloxifene is a representative of II. generation of Selective Estrogen Receptor Modulators (SERM). Raloxifene reduces the risk of clinical vertebral frac tures by 68 % at 1 year and the risk of nonvertebral fractures by 47 % at 36 months in patients with high fracture risk. In a big group of patients the per centage changes in BMD accounted for about 4 % of the total vertebral fracture risk reduction and fracture risk decrease for any percentage changes in BMD. The fracture risk is lowest in the patients with the biggest decrease of bone marker at six months of raloxifene treatment, at twelve months of raloxifene treatment only moderate decrease of bone marker indicated reduction of fracture risk. In individual patient change in BMD has to take in account LSC (least significant change) for the machine and for the operator. Examination of bone markers confirms, that the patient responds to the treatment by expected degree of remodeling supression.
Conclusion: In individual patient remaining or increasing BMD confirms the efficiency of the treatment by raloxifene. It is possible to confirm this res ponse by decrease of bone resorption marker. Decrease in BMD bigger than LSC of the machine and simultaneous remaining of increasing value of bone marker indicate an inadequate response of skeleton to the treatment and should lead to an reevalution of the original diagnosis or change of the treatment.
Keywords: raloxifene, fracture risk, monitoring of treatment. Osteologický bulletin SOOä, S^.Sô-SS
Published: December 11, 2003 Show citation
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