Raloxifeno e osteoporose: revisão de um novo modulador seletivo do receptor de estrógeno

• Autor(a) principal: Kayath, Marcia J. [UNIFESP]
• Data de Publicação: 1999
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-27301999000600008; http://repositorio.unifesp.br/handle/11600/864
• topic: Raloxifene; Estrogen; SERM; Osteoporosis; Breast cancer; Lipids; Raloxifeno; Estrógeno; SERM; Osteoporose; Câncer de mama; Lípides

Raloxifene is a selective estrogen receptor modulator of second generation with agonist effect in the bone, cardiovascular system, and antagonist effect in the breast and uterus. The tissue selectivity of raloxifene occurs due to several mechanisms such as different estrogen receptors, differential distribution of receptors, different protein transcriptional factors and receptor conformation after raloxifene binding. In bone, raloxifene increases the bone mass in the spine, femur and total body, prevents osteoporosis in postmenopausal women and reduces the incidence of vertebral fractures in 50% in women with osteoporosis. In the cardiovascular system, raloxifene decreases total cholesterol, LDL-cholesterol, fibrinogen and lipoprotein (a), without changes in triglycerides and HDL-cholesterol, however, it increases the subfraction HDL-C2. Raloxifene has antiproliferative activity in the breast, does not induce mastalgia and a reduction in the incidence of new cases of breast cancer has been found in women taking raloxifene in the large osteoporosis trials. In the uterus, raloxifene does not stimulate the endometrium and does not increase the incidence of vaginal bleeding or endometrial carcinoma. The most common adverse event with ralox-ifene is hot flashes and the most serious is venous thromboembolism with similar incidence as hormonal replacement therapy. Raloxifene is an alternative with evidence of selective beneficial effects in other tissues. Other potential benefits with raloxifene such as cardiovascular protection and breast cancer prevention are being investigated in long-term clinical trials.