[Effects of SERMs on bone health. SERM and metabolic markers of bone].

Raloxifene is the only SERM available in Japan. The effect on bone metabolism is relatively mild and slow compared with that of bisphosphonates, and reaches plateau after 6th month or later. As diurnal variations of metabolic markers, especially urinary markers are large, it is often difficult to confirm the effect of raloxifen on bone by individual base. The strict sampling time before and after treatment, and/or selection of patients with high turnover bone may help to increase the chance to confirm the raloxifene effect. A new type of SERM bone marker such as tartrate resistant acid phosphatase fraction 5b is expected to improve the chance. Some papers suggest the relation between suppression of bone markers by raloxifene and vertebral fractures, but the relation is not usually confirmed due to wide variations of the markers.