Ohta Hiroaki
International University of Health and Welfare/Sanno Medical Center, Women's Medical Center.
Clin Calcium. 2011 Jan;21(1):34-42.
Bazedoxifene is a new-generation SERM with a novel chemical structure, which has been developed to provide improved efficacy on the bone and the lipid profile, as well as improved safety for breast and endometrial tissues. A statistically significant 42% reduction in the incidence of new vertebral fractures has been reported with bazedoxifene treatment in an overseas phase III trial, equal to that reported with the bisphosphonates and raloxifene. A significant reduction in the incidence of non-vertebral fractures was also shown with bazedoxifene, compared to placebo and raloxifene in the high-risk population in a post-hoc analysis. These data suggest that bazedoxifene could be more effective in reducing the risk for non-vertebral fractures than raloxifene. Bazedoxifene has demonstrated a favorable safety and tolerability profile with no significant differences observed among the treatment groups in coronary artery events, cerebrovascular events, and overall death rates. The incidence of adverse events, such as VTEs, hot flushes and leg cramps, reported as a class effect of the SERMs, were higher with bazedoxifene than with placebo, but was similar to that with raloxifene. Bazedoxifene is thus expected to become an important new option for the treatment of postmenopausal osteoporosis in Japan.
巴多昔芬是一种具有新型化学结构的新一代选择性雌激素受体调节剂(SERM),其研发目的是提高对骨骼和脂质状况的疗效,并改善对乳腺和子宫内膜组织的安全性。在一项海外III期试验中,据报道巴多昔芬治疗可使新发椎体骨折的发生率显著降低42%,与双膦酸盐类药物和雷洛昔芬的疗效相当。在一项事后分析中,与安慰剂和雷洛昔芬相比,在高危人群中巴多昔芬也显示出非椎体骨折发生率的显著降低。这些数据表明,巴多昔芬在降低非椎体骨折风险方面可能比雷洛昔芬更有效。巴多昔芬已显示出良好的安全性和耐受性,在治疗组之间的冠状动脉事件、脑血管事件和总死亡率方面未观察到显著差异。作为SERM类药物的共同效应而报告的不良事件,如静脉血栓栓塞、潮热和腿部痉挛,巴多昔芬组的发生率高于安慰剂组,但与雷洛昔芬组相似。因此,巴多昔芬有望成为日本绝经后骨质疏松症治疗的一个重要新选择。