Recommendations for raloxifene use in daily clinical practice in the Swiss setting.

Détails

ID Serval
serval:BIB_A966BDC0D68F
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Recommendations for raloxifene use in daily clinical practice in the Swiss setting.
Périodique
European Spine Journal
Auteur⸱e⸱s
Lippuner K., Buchard P.A., De Geyter C., Imthurn B., Lamy O., Litschgi M., Luzuy F., Schiessl K., Stute P., Birkhäuser M.
ISSN
1432-0932 (Electronic)
ISSN-L
0940-6719
Statut éditorial
Publié
Date de publication
06/2012
Peer-reviewed
Oui
Volume
21
Numéro
12
Pages
2407-2417
Langue
anglais
Notes
Publication types: Journal Article
WOS Document Type: Review
Résumé
BACKGROUND/AIM: Raloxifene is the first selective estrogen receptor modulator that has been approved for the treatment and prevention of osteoporosis in postmenopausal women in Europe and in the US. Although raloxifene reduces the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer, it is approved in that indication in the US but not in the EU. The aim was to characterize the clinical profiles of postmenopausal women expected to benefit most from therapy with raloxifene based on published scientific evidence to date.
METHODS: Key individual patient characteristics relevant to the prescription of raloxifene in daily practice were defined by a board of Swiss experts in the fields of menopause and metabolic bone diseases and linked to published scientific evidence. Consensus was reached about translating these insights into daily practice.
RESULTS: Through estrogen agonistic effects on bone, raloxifene reduces biochemical markers of bone turnover to premenopausal levels, increases bone mineral density (BMD) at the lumbar spine, proximal femur, and total body, and reduces vertebral fracture risk in women with osteopenia or osteoporosis with and without prevalent vertebral fracture. Through estrogen antagonistic effects on breast tissue, raloxifene reduces the risk of invasive estrogen-receptor positive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer. Finally, raloxifene increases the incidence of hot flushes, the risk of venous thromboembolic events, and the risk of fatal stroke in postmenopausal women at increased risk for coronary heart disease. Postmenopausal women in whom the use of raloxifene is considered can be categorized in a 2 × 2 matrix reflecting their bone status (osteopenic or osteoporotic based on their BMD T-score by dual energy X-ray absorptiometry) and their breast cancer risk (low or high based on the modified Gail model). Women at high risk of breast cancer should be considered for treatment with raloxifene.
CONCLUSION: Postmenopausal women between 50 and 70 years of age without climacteric symptoms with either osteopenia or osteoporosis should be evaluated with regard to their breast cancer risk and considered for treatment with raloxifene within the framework of its contraindications and precautions.
Mots-clé
Absorptiometry, Photon, Aged, Aged, 80 and over, Algorithms, Bone Density, Bone Diseases, Metabolic/diagnosis, Cohort Studies, Computer Graphics, Female, Heel/ultrasonography, Hip/ultrasonography, Humans, Lumbar Vertebrae/ultrasonography, Middle Aged, Osteoporosis, Postmenopausal/complications, Osteoporosis, Postmenopausal/diagnosis, Osteoporotic Fractures/diagnosis, Osteoporotic Fractures/etiology, Predictive Value of Tests, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Switzerland
Pubmed
Web of science
Création de la notice
10/01/2013 16:16
Dernière modification de la notice
20/08/2019 16:13
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