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盐酸雷洛昔芬,一种选择性雌激素受体调节剂:绝经后女性认知功能和情绪影响的安全性评估

Raloxifene hydrochloride, a selective estrogen receptor modulator: safety assessment of effects on cognitive function and mood in postmenopausal women.

作者信息

Nickelsen T, Lufkin E G, Riggs B L, Cox D A, Crook T H

机构信息

Lilly Deutschland GmbH, Bad Homburg, Germany.

出版信息

Psychoneuroendocrinology. 1999 Jan;24(1):115-28. doi: 10.1016/s0306-4530(98)00041-9.

DOI:10.1016/s0306-4530(98)00041-9
PMID:10098223
Abstract

Raloxifene hydrochloride (HCl) is a selective estrogen receptor modulator with estrogen agonist effects on bone and lipid metabolism and estrogen antagonist effects on reproductive tissues. Animal studies suggest that raloxifene may affect brain function as well, although the effects of raloxifene on the human brain remain to be established. This paper presents an early safety assessment of raloxifene effects on cognition and mood in postmenopausal women participating in a randomized, double-blind osteoporosis treatment trial. Psychometric test batteries were administered to postmenopausal women at baseline and 1, 6, and 12 months after initiating treatment with raloxifene (60 and 120 mg/day). The Memory Assessment Clinics (MAC) battery and Walter Reed Performance Assessment Battery (PAB) were used to assess multiple and independent aspects of cognitive function, while mood was assessed with the Geriatric Depression Scale (GDS). After 12 months of treatment, there were no significant differences between the raloxifene groups and placebo on performance in either the MAC battery or the PAB. The only significant difference observed was a slight increase in performance favoring the raloxifene 120 mg/day group in an assessment of verbal memory on the MAC battery after 1 month of treatment. Scores on the GDS and the self-reported incidence of mood-related events were not different between treatment groups at any of the assessment periods. These data do not suggest that raloxifene impairs cognition or affects mood in postmenopausal women treated for 1 year. Studies to further assess the safety and potential efficacy of raloxifene with respect to cognitive function are ongoing.

摘要

盐酸雷洛昔芬是一种选择性雌激素受体调节剂,对骨骼和脂质代谢具有雌激素激动作用,对生殖组织具有雌激素拮抗作用。动物研究表明,雷洛昔芬可能也会影响脑功能,尽管雷洛昔芬对人脑的影响尚待确定。本文对参与一项随机、双盲骨质疏松症治疗试验的绝经后女性中雷洛昔芬对认知和情绪的影响进行了早期安全性评估。在基线以及开始使用雷洛昔芬(60毫克/天和120毫克/天)治疗后的1、6和12个月,对绝经后女性进行了心理测量测试组评估。使用记忆评估诊所(MAC)测试组和沃尔特·里德性能评估测试组(PAB)来评估认知功能的多个独立方面,同时使用老年抑郁量表(GDS)评估情绪。治疗12个月后,雷洛昔芬组与安慰剂组在MAC测试组或PAB测试组中的表现均无显著差异。观察到的唯一显著差异是,在治疗1个月后,在MAC测试组的言语记忆评估中,雷洛昔芬120毫克/天组的表现略有提高。在任何评估期,治疗组之间在GDS得分和自我报告的情绪相关事件发生率方面均无差异。这些数据并不表明雷洛昔芬会损害接受1年治疗的绝经后女性的认知或影响其情绪。关于雷洛昔芬在认知功能方面的安全性和潜在疗效的进一步评估研究正在进行中。

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