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Effect of Raloxifene on all-cause mortality
Deborah Grady1, Jane A Cauley, John L Stock
1University of California, San Francisco, CA 94115, USA. deborah.grady@ucsf.edu
The American Journal of Medicine
|April 20, 2010
Summary
Raloxifene (60 mg/day) reduced all-cause mortality by 10% in postmenopausal women. This benefit was mainly due to fewer noncardiovascular, noncancer deaths, suggesting a potential survival advantage.
Area of Science:
- Pharmacology and Therapeutics
- Gerontology and Geriatric Medicine
- Cardiovascular Disease Prevention
Background:
- Raloxifene, a selective estrogen receptor modulator, is used for osteoporosis and breast cancer prevention.
- It carries known risks including venous thromboembolism and stroke, particularly in women with coronary heart disease.
Purpose of the Study:
- To evaluate the overall and cause-specific mortality risk/benefit of raloxifene as a preventative treatment.
- To analyze the impact of raloxifene on mortality in postmenopausal women at risk.
Main Methods:
- Pooled analysis of mortality data from two large clinical trials: Multiple Outcomes of Raloxifene Evaluation/Continuing Outcomes Relevant to Evista and Raloxifene Use for the Heart.
- Included over 17,800 postmenopausal women treated with raloxifene (60 mg/day) or placebo.
- Cox proportional hazards regression models were used to compare mortality rates.
Main Results:
- All-cause mortality was 10% lower in the raloxifene group compared to placebo (Relative Hazard: 0.90; 95% CI: 0.80-1.00; P=.05).
- The reduction in overall mortality was primarily driven by lower rates of noncardiovascular deaths.
- Specifically, a significant reduction was observed in noncardiovascular, noncancer deaths.
Conclusions:
- Pooled analyses indicate that raloxifene (60 mg/day) significantly reduces all-cause mortality in postmenopausal women.
- The primary mechanism for this mortality reduction appears to be a decrease in noncardiovascular, noncancer deaths.
- The exact mechanism by which raloxifene confers this survival benefit remains to be elucidated.
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