Jewish World Review Nov. 26, 2002 / 21 Kislev, 5763


Osteoporosis drug cuts stroke risk

By Peggy Peck

http://www.NewsAndOpinion.com | (UPI) A drug used to prevent osteoporosis also seems to cut the risk for stroke by more than 60 percent in post-menopausal women, researchers said Wednesday.

The drug, raloxifene, is a selective estrogen receptor modulator (SERM). Though not a hormone, this type of drug binds to estrogen receptors in cells. Such drugs have some but not all of the effects of estrogen and in some cases block the action of estrogen -- hence the term "selective."

Heart researcher Dr. Elizabeth Barrett-Conner, professor of medicine at the University of California, San Diego, said raloxifene might offer better stroke protection because unlike estrogen it does not promote inflammation, which is considered a risk factor for stroke.

As she reported at the American Heart Association's Scientific Sessions 2002, Barrett-Conner analyzed data from a study of raloxifene for the prevention of osteoporosis, in which more than 7,500 women were enrolled. Half of them took raloxifene -- marketed under the brand name Evista -- and half took a sham medication, or placebo.

Barrett-Conner used a risk factor measurement to identify women who were enrolled in the osteoporosis trial who also had heart disease or a high risk for heart disease or stroke. She identified 1,035 women who fit this profile.

Among those high risk women, those who took raloxifene reduced their risk for stroke by "62 percent compared to the women in the placebo group," says Barrett-Conner. That stands in stark contrast to findings from a recent study of standard hormone replacement therapy that found a 41 percent increase in risk for stroke.

After leaping to conclusions about the ability of hormone replacement to reduce the risk for heart disease, however, heart specialists seem to be reacting with more caution than optimism to the early word on raloxifene.

Dr. Richard C. Pasternak, professor of medicine at Harvard Medical School in Cambridge, Mass., said although "this news is promising," it is too soon to recommend Evista as a way to reduce stroke risk. This time around, Pasternak said, doctors and women need to wait for solid evidence. Pasternak was not involved in the Evista study.

Barrett-Conner said such evidence could come from a "large prospective study (of raloxifene). That study has recruited 10,000 women worldwide." She said the study enrolled both healthy women and women with heart disease, so when concludes, sometime in late 2007, "we will know if raloxifene can prevent heart disease and if it can slow progression in people who already have disease."

Until then, Barrett-Conner agreed it is too soon promote raloxifene as "a pill to prevent heart disease." Moreover, she said even raloxifene is not without risk. Like estrogen, it increases incidences of blood clots in the legs or lungs.

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