Díez J L
School of Medicine, University of Seville, Spain.
Hum Reprod Update. 2000 May-Jun;6(3):255-8. doi: 10.1093/humupd/6.3.255.
Women suffer a higher incidence of osteoporosis than men, in part due to oestrogen deficiency after menopause. In fact, the administration of oestrogen to post-menopausal women is associated with a decrease of bone resorption. Tamoxifen is a widely used selective oestrogen receptor modulator in women with breast cancer, which has been shown an agonistic profile in bone. However, tamoxifen seems less effective than oestradiol as an anti-resorptive agent and has no effect when the endogenous production of oestrogen is normal. Additionally, tamoxifen exhibits agonistic activity on the endometrium and has been suggested an oncogenic potential on that tissue. Raloxifene, a selective oestrogen receptor modulator from the benzothiophene family, behaves also as an agonist on the bone in both laboratory and clinical studies. Ongoing clinical trials confirm a protective effect of raloxifene similar to oestrogens. The Multiple Outcome of Raloxifene Evaluation (MORE) study is a prospective, randomized trial which, in a recent 2 year interim analysis, has shown that women suffering from osteoporosis receiving raloxifene had 42% fewer vertebral fractures than women receiving a placebo.
女性患骨质疏松症的发病率高于男性，部分原因是绝经后雌激素缺乏。事实上，给绝经后女性服用雌激素与骨吸收减少有关。他莫昔芬是一种广泛用于乳腺癌女性的选择性雌激素受体调节剂，已显示在骨骼方面具有激动剂特性。然而，作为一种抗吸收剂，他莫昔芬似乎不如雌二醇有效，并且当雌激素内源性分泌正常时它没有效果。此外，他莫昔芬对子宫内膜表现出激动活性，并被认为在该组织上具有致癌潜力。雷洛昔芬是一种来自苯并噻吩家族的选择性雌激素受体调节剂，在实验室和临床研究中在骨骼上也表现为激动剂。正在进行的临床试验证实雷洛昔芬具有与雌激素相似的保护作用。雷洛昔芬评估多项结果（MORE）研究是一项前瞻性随机试验，在最近的一项为期2年的中期分析中表明，患有骨质疏松症的女性服用雷洛昔芬比服用安慰剂的女性椎体骨折少42%。
