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Raloxifene as a multifunctional medicine?

BMJ 1999; 319 doi: (Published 07 August 1999) Cite this as: BMJ 1999;319:331

Current trials will show whether it is effective in both osteoporosis and breast cancer

  1. V Craig Jordan, professor of cancer pharmacology,
  2. M Morrow, professor of surgery
  1. Robert H. Lurie Comprehensive Cancer Center, Northwestern University Medical School, Chicago, Illinois 60611, USA

    Recent developments in the new endocrinology of selective oestrogen receptor modulators (SERMs) seem to have the potential to transform therapeutics. The emerging data on the multiple effects of raloxifene have generated great excitement that this might be the first multifunctional medicine. Raloxifene was developed for preventing osteoporosis and, like oestrogen, may reduce the risk of cardiovascular disease. In addition, raloxifene may reduce the incidence of breast cancer without increasing that of endometrial cancer. Selective oestrogen receptor modulators such as raloxifene introduce important new concepts for the physician, but how did we get to this point and what is the evidence to support the claims?

    The description of the target site specificity of tamoxifen and raloxifene opened the door for novel applications of the drugs originally known as non-steroidal antiestrogens.1 2 Until then the drugs had been considered only as treatments for breast cancer,3 but then tamoxifen was advanced as a breast cancer preventive agent in high risk women.4 Tamoxifen would never have been acceptable as a preventive agent if it had had an antioestrogenic action on bone, resulting in an increased incidence of osteoporosis. …

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