Raloxifene for Osteoporosis in Postmenopausal Women with Rheumatic Diseases

Won Seok Lee¹, Yun Jung Choi², Yun-Hong Cheon¹, Myong-Joo Hong³, Chang-Hoon Lee⁴, Myeung Su Lee⁴, Sang-Il Lee⁵ and Wan-Hee Yoo⁶, ¹Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, South Korea, ²Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, JeonJu, South Korea, ³Department of internal Medicine, Presbyterian Medical center, Jeonju, South Korea, ⁴Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Chonbuk, South Korea, ⁵Division of Rheumatology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea, ⁶Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, South Korea

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: menopause, osteoporosis and rheumatic disease

Session Information

Title: Osteoporosis and Metabolic Bone Disease - Clinical Aspects and Pathogenesis: Osteoporosis: Treatment, Safety, and Long Term Outcomes

Session Type: Abstract Submissions (ACR)

Background/Purpose : Raloxifen is a selective estrogen receptor modulator that has been extensively studied. We studied the efficacy of raloxifene on disease activity and bone mineral density (BMD) in postmenopausal women with rheumatic diseases receiving long-term glucocorticoids (GC).

Methods: Postmenopausal women with rheumatic diseases and osteoporosis were included. Patients with a history of thromboembolism or antiphospholipid antibody positivity were excluded. They were managed with raloxifene (60 mg/day) plus elemental calcium (1,200 mg/day). BMD of the hip and spine (primary outcome) was measured initially and at month 12, and disease activity (secondary outcome) was serially assessed using DAS28 and SELENA-SLEDAI.

Results: Between January 2010 and December 2013, 130 patients (86 assigned to receive GC and 44 patients not receiving GC, mean ± SD age 60.1 ± 9.0 vs. 59.3 ± 7.0 years) were recruited. 81 rheumatoid arthritis, 15 Sjogren’s syndrome, 11 scleroderma, 11 Behcet’s disease, 7 lupus and 5 other rheumatic diseases were included. Demographic data, osteoporotic risk factors and BMD at various sites were similar between the two groups of patients. The duration and dose of prednisolone received was 72.5 ± 24 months and 3.3 ± 1.6 mg/day. At month 12, a significant gain in the lumbar spine (+0.9 ± 0.7%; p = 0.04 vs. +0.4 ± 0.1%; p=0.05) and total hip BMD (+1.1 ± 0.5%; p = 0.03vs. 1.5 ± 0.7%; p = 0.04) was observed in patients receiving GC or not. However, femoral neck BMD was decreased in both groups. No patient had a major flare of lupus and rheumatoid arthritis. No fracture and thromboembolic events were reported.

Conclusion: Raloxifene was well tolerated in postmenopausal female patients with rheumatic diseases who had inactive disease and in whom hypercoagulability was not identified. Raloxifene increased total hip and lumbar spinal BMD in patients receiving corticosteroids or not.

Disclosure:

W. S. Lee,
None;

Y. J. Choi,
None;

Y. H. Cheon,
None;

M. J. Hong,
None;

C. H. Lee,
None;

M. S. Lee,
None;

S. I. Lee,
None;

W. H. Yoo,
None.

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