Sambrook Philip
Institute of Bone and Joint Research, Building 36, Royal North Shore Hospital, St Leonards, Sydney 2065, Australia.
Best Pract Res Clin Rheumatol. 2005 Dec;19(6):975-81. doi: 10.1016/j.berh.2005.06.007.
Clinical trials have demonstrated that the selective estrogen receptor modulator raloxifene can reduce the risk of vertebral fracture, but have not unequivocally demonstrated an effect on non-vertebral fracture. Consequently it is recommended that raloxifene be used mainly in postmenopausal women with milder osteoporosis as a preventive measure or for treatment in those with predominantly spinal osteoporosis. Since the effects of raloxifene on bone mineral density and bone turnover may reverse soon after cessation, it is recommended that raloxifene be used as long-term therapy for 5-10 years. Because of its quicker offset, use of raloxifene may have advantages over potent bisphosphonates if use of anabolic agents are contemplated in an individual patient.
临床试验表明，选择性雌激素受体调节剂雷洛昔芬可降低椎体骨折风险，但尚未明确证明其对非椎体骨折有效果。因此，建议雷洛昔芬主要用于患有轻度骨质疏松症的绝经后女性，作为一种预防措施，或用于主要患有脊柱骨质疏松症的患者的治疗。由于雷洛昔芬对骨矿物质密度和骨转换的作用在停药后可能很快逆转，因此建议将雷洛昔芬作为5至10年的长期治疗药物。由于其作用消失更快，如果考虑在个体患者中使用合成代谢药物，雷洛昔芬的使用可能比强效双膦酸盐具有优势。
