To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Drug That Treats Osteoporosis Also Decreases Risk Of Breast Cancer URL: http://www.pslgroup.com/dg/107BBE.htm Doctor's Guide June 15, 1999
CHICAGO, IL -- June 15, 1999 -- Postmenopausal women with osteoporosis who were treated with raloxifene hydrochloride (Evista) for three years lessened their risk of invasive breast cancer by 76 percent, according to an article in the June 16 issue of The Journal of the American Medical Association (JAMA). Steven R. Cummings, M.D., of the University of California at San rancisco, and colleagues report on the Multiple Outcomes of Raloxifene Evaluation (MORE) randomized trial. The MORE trial is composed of information from 180 clinical centers in 25 countries (mostly in the United States and Europe).
The study included a total of 7,705 postmenopausal women younger than 81 years old with osteoporosis. Of these women, 2,572 were randomly assigned to receive 120 milligrams (mg) of raloxifene (two 60 mg tablets) daily; 2,557 were randomly assigned to receive 60 mg (one 60 mg tablet and a placebo tablet) daily and 2,576 women were randomly assigned to receive two placebo tablets daily.
Thirteen cases of breast cancer were confirmed among the 5,129 women who received raloxifene; 27 cases of breast cancer were confirmed among the 2,576 women in the placebo group.
"Raloxifene reduced the risk of newly diagnosed invasive breast cancer by 76 percent during a median of 40 months of treating postmenopausal women for osteoporosis," the authors write. "This was attributable to a 90 percent reduction in the risk of estrogen receptor-positive breast cancer. There was no apparent decrease in the risk of estrogen receptor breast cancer. This supports the concept that raloxifene acts by interacting with estrogen receptors in the breast to competitively inhibit estrogen-induced DNA transcription."
The authors add that to prevent one case of breast cancer, 126 women would need to be treated with raloxifene.
Raloxifene is a drug that has been approved by the Food and Drug Administration for the prevention of osteoporosis in postmenopausal women and is classified as a selective estrogen receptor modulator (SERM).
According to the authors, raloxifene hydrochloride has estrogenic effects on bone, lipid metabolism and blood clotting, but does not have estrogenic effects on breast and endometrial tissue. Raloxifene fits into estrogen receptors and blocks the effects of estrogen on breast cancer and endometrial tissue, but activates the estrogen receptors that provide the beneficial effects of estrogen for bones (increasing bone density and decreasing bone turnover).
Three years of treatment with raloxifene decreased the risk of vertebral fractures but not the risk of other types of fractures. Raloxifene also showed some of the beneficial estrogenic effects for lipid metabolism (reducing total cholesterol and lowering blood levels of low-density lipoprotein (LDL) cholesterol - the "bad cholesterol").
Raloxifene also appears to activate the estrogen receptors that can lead to abnormal blood clotting, which increases the risk of complications caused by blocked blood vessels. "One case of venous thromboembolism occurred per 155 women treated with raloxifene for three years," according to the authors.
"The risk of venous thromboembolic disease (deep venous thrombosis or pulmonary embolism) was 3.1 times higher in women assigned to the raloxifene group than to the placebo group."
"Because venous thromboembolism is an uncommon disease, the three-fold increase in risk translated to a 0.6 percent excess risk of venous thromboembolic disease during three years of treatment," according to the authors. "Women with a history of venous thrombosis or pulmonary embolism should not take raloxifene, tamoxifen or estrogen, and women currently taking any of these medication should discontinue them before major surgery or during periods of immobilization."
The authors also report that estrogen hormones can cause thickening of endometrial tissue (tissue that lines the inner walls of the uterus) and can stimulate the growth of certain breast cancers. "Adenocarcinoma [cancerous growth of surface cells in glandular or gland-like pattern] of the breast is the most common cancer and the second leading cause of cancer death among women in the United States," according to the authors.
"About 43,500 U.S. women died of breast cancer in 1998," the authors write. "Estrogen plays an important role in the pathogenesis of breast cancer. Postmenopausal women with high serum concentrations of estradiol [naturally occurring estrogen hormone in mammals] have the highest risk of breast cancer. A number of other risk factors associated with longer or greater exposure to estrogen increase the risk of developing breast cancer." (JAMA. 1999;281:2189-2196) --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.