Treatment of Postmenopausal Osteoporosis By Evista (raloxifene) and Fasomax ( alendronate)A Comparable study


Background :A new group of pharmaceutical substances for treatment of postmenopausal osteoporosis, named Selective Estrogen Receptor Modulators (SERMS). Evista (raloxifene) is the recent generation of SERMS, which acts through the binding with estrogen receptors in such a way that it acts as an estrogen agonist on bone and cardiovascular system while acting as an estrogen antagonist on breast and endometrium . Another new drug, named Fasomax (alendronate), is stable analog of inorganic pyrophosphate, which acts through binding to the bone mineral surface and inhibit osteoclastic bone resorption.Objective : This study is focused to compare the effects of Evista (raloxifene) and Fasomax (alendronate) on the bone mineral density and bone quality in postmenopausal women with osteoporosis.Methods: A prospective study done in Dar-Alshifa hospital (Abu-Dhabie), on 100 patients with postmenopausal steoporosis. These patients were randomized in two groups, Evista (raloxifene) and Fasomax (alendronate) treated groups, in both the results compared with a placebo group.Bone mineral density was performed regularly in our centre.Histomorphometry was performed on transiliac bone biopsy taken from volunteers in the central laboratory.Results: In all treated patients whether by Evista(raloxifene) or Fasomax(alendronate), newly formed bone retained its normal lamellar structure, and there was no evidence for marrow fibrosis or cellular toxicity. The increase in bone mineral density was 4% with Evista and 16% with Fasomax.Conclusion: Both Evista and Fasomax maintain the normal quality of bone. Evista has more extraskeletal beneficial effect esp. on lipid profile. Key words : evista, raloxifene, fasomax, alendronate, postmenopausal osteoporosis, histomorphometry, bone remodeling.Keywords: evista, raloxifene, fasomax, alendronate, postmenopausal osteoporosis, histomorphometry, bone remodeling.