Objectives To study 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 was measured initially and at month 12, and disease activity was serially assessed using SLEDAI and DAS28.
Results The study group comprised 130 patients (81 rheumatoid arthritis, 7 lupus, 15 Sjogren's syndrome, 11 scleroderma, 11 Behcet's disease and 5 other rheumatic diseases, 86 assigned to receive GC and 44 patients not receiving GC, mean ± SD age 60.1±9.0 vs. 59.3±7.0 years). 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.
Conclusions 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 of Interest None declared
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