Goldstein S R, Neven P, Zhou L, Taylor Y L, Ciaccia A V, Plouffe L
Department of Obstetrics and Gynecology, New York University Medical Center, New York, New York, USA.
Obstet Gynecol. 2001 Jul;98(1):91-6. doi: 10.1016/s0029-7844(01)01390-4.
To assess the effects of raloxifene therapy on the frequency of surgery for pelvic floor relaxation in postmenopausal women.
This analysis used safety data through 3 years of treatment from three double-masked, placebo-controlled, randomized trials of raloxifene, which included 6926 postmenopausal women with uteri at entry. Studies 1 and 2 enrolled 969 nonosteoporotic, postmenopausal women who were assigned to 30, 60, or 150 mg per day raloxifene or placebo. Study 3 enrolled 5957 osteoporotic, postmenopausal women randomized to raloxifene 60 or 120 mg per day or placebo. Indications for any reported pelvic operations were identified, including procedures performed for pelvic organ prolapse or urinary incontinence.
A total of 34 (1.51%) women in the placebo group and 35 (0.75%) raloxifene-treated women underwent surgical procedures for pelvic floor relaxation. The odds ratio (and 95% confidence interval) for pelvic floor repair in women assigned to raloxifene was 0.50 (0.31, 0.81). Thus, raloxifene therapy was associated with a significantly reduced risk for pelvic floor surgery (P <.005).
Raloxifene does not increase pelvic floor relaxation. An apparent protective effect on pelvic floor function warrants further investigation.
评估雷洛昔芬治疗对绝经后女性盆底松弛手术发生率的影响。
本分析使用了来自三项雷洛昔芬双盲、安慰剂对照、随机试验的3年治疗安全性数据,这些试验纳入了6926名绝经后子宫完整的女性。研究1和2招募了969名非骨质疏松性绝经后女性,她们被分配接受每日30、60或150毫克雷洛昔芬或安慰剂治疗。研究3招募了5957名骨质疏松性绝经后女性,她们被随机分配接受每日60或120毫克雷洛昔芬或安慰剂治疗。确定了所有报告的盆腔手术指征,包括因盆腔器官脱垂或尿失禁而进行的手术。
安慰剂组共有34名(1.51%)女性和雷洛昔芬治疗组的35名(0.75%)女性接受了盆底松弛手术。接受雷洛昔芬治疗的女性进行盆底修复的比值比(及95%置信区间)为0.50(0.31,0.81)。因此,雷洛昔芬治疗与盆底手术风险显著降低相关(P<.005)。
雷洛昔芬不会增加盆底松弛。其对盆底功能的明显保护作用值得进一步研究。