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001-es BibID:	BIBFORM042776
Első szerző:	Ettinger, Bruce
Cím:	Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene : results from a 3-year randomized clinical trial / Bruce Ettinger, Dennis M. Black, Bruce H. Mitlak, Ronald K. Knickerbocker, Thomas Nickelsen, Harry K. Genant, Claus Christiansen, Pierre D. Delmas, Jose R. Zanchetta, Jacob Stakkestad, Claus C. Glüer, Kathryn Krueger, Fredric J. Cohen, Stephen Eckert, Kristine E. Ensrud, Louis V. Avioli, Paul Lips, Steven R. Cummings, for the Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators
Dátum:	1999
Megjegyzések:	Raloxifene hydrochloride, a selective estrogen receptor modulator, prevents bone loss in postmenopausal women, but whether it reduces fracture risk in these women is not known.OBJECTIVE:To determine the effect of raloxifene therapy on risk of vertebral and nonvertebral fractures.DESIGN:The Multiple Outcomes of Raloxifene Evaluation (MORE) study, a multicenter, randomized, blinded, placebo-controlled trial.SETTING AND PARTICIPANTS:A total of 7705 women aged 31 to 80 years in 25 countries who had been postmenopausal for at least 2 years and who met World Health Organization criteria for having osteoporosis. The study began in 1994 and had up to 36 months of follow-up for primary efficacy measurements and nonserious adverse events and up to 40 months of follow-up for serious adverse events.INTERVENTIONS:Participants were randomized to 60 mg/d or 120 mg/d of raloxifene or to identically appearing placebo pills; in addition, all women received supplemental calcium and cholecalciferol.MAIN OUTCOME MEASURES:Incident vertebral fracture was determined radiographically at baseline and at scheduled 24- and 36-month visits. Nonvertebral fracture was ascertained by interview at 6-month-interim visits. Bone mineral density was determined annually by dual-energy x-ray absorptiometry.RESULTS:At 36 months of the evaluable radiographs in 6828 women, 503 (7.4%) had at least 1 new vertebral fracture, including 10.1% of women receiving placebo, 6.6% of those receiving 60 mg/d of raloxifene, and 5.4% of those receiving 120 mg/d of raloxifene. Risk of vertebral fracture was reduced in both study groups receiving raloxifene (for 60-mg/d group: relative risk [RR], 0.7; 95% confidence interval [CI], 0.5-0.8; for 120-mg/d group: RR, 0.5; 95% CI, 0.4-0.7). Frequency of vertebral fracture was reduced both in women who did and did not have prevalent fracture. Risk of nonvertebral fracture for raloxifene vs placebo did not differ significantly (RR, 0.9; 95% CI, 0.8-1.1 for both raloxifene groups combined). Compared with placebo, raloxifene increased bone mineral density in the femoral neck by 2.1 % (60 mg) and 2.4% (120 mg) and in the spine by 2.6% (60 mg) and 2.7% (120 mg) P<0.001 for all comparisons). Women receiving raloxifene had increased risk of venous thromboembolus vs placebo (RR, 3.1; 95% CI, 1.5-6.2). Raloxifene did not cause vaginal bleeding or breast pain and was associated with a lower incidence of breast cancer.CONCLUSIONS:In postmenopausal women with osteoporosis, raloxifene increases bone mineral density in the spine and femoral neck and reduces risk of vertebral fracture.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban külföldön készült közlemény
Megjelenés:	JAMA : the Journal of the American Medical Association. - 282 : 7 (1999), p. 637-645. -
További szerzők:	Black, Dennis M. Mitlak, Bruce H. Knickerbocker, Ronald K. Nickelsen, Thomas Genant, Harry K. Christiansen, Claus Delmas, Pierre D. Zanchetta, Jose R. Stakkestad, Jacob Glüer, Claus C. Krueger, Kathryn Cohen, Fredric J. Eckert, Stephen Ensrud, Kristine E. Avioli, Louis V. Lips, Paul Cummings, Steven R. Balogh Ádám (1940-) (szülész-nőgyógyász, endokrinológus szakorvos) The Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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