The Beneficial and Adverse Effects of Raloxifene in Menopausal Women: A Mini Review

다국어 초록 (Multilingual Abstract)

Objectives: The present mini review aimed to summarize the existing knowledge regarding the beneficial and adverse effects of raloxifene in menopausal women. Methods: This study is a review of relevant publications about the effects of raloxifene on sleep disorder, depression, venous thromboembolism, the plasma concentration of lipoprotein, breast cancer, and cognitive function among menopausal women.Results: Raloxifene showed no significant effect on depression and sleep disorder. Verbal memory improved with administration of 60 mg/day of raloxifene while a mild cognitive impairment risk reduction by 33% was observed with administration of 120 mg/ day of raloxifene. Raloxifene was associated with a 50% decrease in the need for prolapse surgery. The result of a meta-analysis showed a significant decline in the plasma concentration of lipoprotein in the raloxifene group compared to placebo (standardized mean difference, -0.43; 10 trials). A network meta-analysis showed that raloxifene significantly decreased the risk of breast cancer (relative risk, 0.572; 95% confidence interval, 0.327-0.881; P = 0.01). In terms of adverse effects of raloxifene, the odds ratio (OR) was observed to be 1.54 (P = 0.006), indicating 54% increase in the risk of deep vein thrombosis (DVT) while the OR for pulmonary embolism (PE) was 1.05, suggesting a 91% increase in the risk of PE alone (P = 0.03). Conclusions: Raloxifene had no significant effect on depression and sleep disorder but decreased the concentration of lipoprotein. Raloxifene administration was associated with an increased risk of DVT and PE and a decreased risk of breast cancer and pelvic organ prolapse in postmenopausal women.

참고문헌 (Reference)

1 Vogel VG, "Update of the national surgical adjuvant breast and bowel project study of tamoxifen and raloxifene (STAR) P-2 trial: Preventing breast cancer" 3 : 696-706, 2010

2 Ko SS, "Treatment of osteoporosis and reduction in risk of invasive breast cancer in postmenopausal women with raloxifene" 12 : 657-674, 2011

3 Konyalioglu S, "The potential antioxidant effect of raloxifene treatment: a study on heart, liver and brain cortex of ovariectomized female rats" 25 : 259-266, 2007

4 Ferretti G, "Raloxifene lowers plasma lipoprotein(a)concentrations : a systematic review and meta-analysis of randomized placebo-controlled trials" 31 : 197-208, 2017

5 Young Hwa Cho, "Raloxifene Administration in Women Treated with Long Term Gonadotropin-releasing Hormone Agonist for Severe Endometriosis: Effects on Bone Mineral Density" 대한폐경학회 22 (22): 174-179, 2016

6 Stearns V, "Paroxetine controlled release in the treatment of menopausal hot flashes : a randomized controlled trial" 289 : 2827-2834, 2003

7 Ismail SI, "Oestrogens for treatment or prevention of pelvic organ prolapse in postmenopausal women" 9 : CD007063-, 2010

8 Woodard GA, "Lipids, menopause, and early atherosclerosis in Study of Women’s Health Across the Nation Heart women" 18 : 376-384, 2011

9 Yousefi Z, "Impacts of herbal medicines on hot flash : A systematic review" 3 : 40-46, 2016

10 Barton D, "Hot flashes : aetiology and management" 18 : 597-606, 2001

11 Walsh BW, "Effects of raloxifene on serum lipids and coagulation factors in healthy postmenopausal women" 279 : 1445-1451, 1998

12 Yang ZD, "Effects of raloxifene on cognition, mental health, sleep and sexual function in menopausal women: a systematic review of randomized controlled trials" 75 : 341-348, 2013

13 Parisa Parsa, "Effects of Group Counseling on Self-care Behaviors in Menopausal Women with Diabetes" 대한폐경학회 23 (23): 108-116, 2017

14 Adomaityte J, "Effect of raloxifene therapy on venous thromboembolism in postmenopausal women. A meta-analysis" 99 : 338-342, 2008

15 Ghazanfarpour M, "Effect of Foeniculum vulgare(fennel)on symptoms of depression and anxiety in postmenopausal women : a double-blind randomised controlled trial" 38 : 121-126, 2018

16 엄미정, "Combination Therapy of Raloxifene and Alendronate for Treatment of Osteoporosis in Elderly Women" 대한폐경학회 23 (23): 56-62, 2017

17 Blumenthal RS, "Cardiovascular effects of raloxifene : the arterial and venous systems" 147 : 783-789, 2004

18 Mocellin S, "Breast cancer chemoprevention: A network meta-analysis of randomized controlled trials" 108 : 2016

19 Auro K, "A metabolic view on menopause and ageing" 5 : 4708-, 2014