[Treatments of Osteoporosis with SERM and their EBM]

Raloxifene is an anti-resorptive agent on bone, regulating turnover by affecting estrogen receptor signals. Reductions in bone metabolic markers become evident in six months after treatment. A large scale randomized clinical trial 3 - 4 years confirmed the 30 - 50% reduction of vertebral fracture risk, similar to the efficacy of nitrogen containing bisphosphonates such as alendronate and risedronate. Risks of non-vertebral fracture were also decreased in patients with severe vertebral fracture treated with raloxifene. Since the anti-fracture effect of raloxifene depends on the regulation of bone metabolism rather than on the increase in bone density, metabolic bone markers seem to useful to monitor the response of patient to the treatment.