Results of systematic review s and meta-analyses of r and omized controlled trials have shown that both systemic estrogen therapy or hormone therapy ( estrogen combined with a progestin ) are useful to prevent bone loss , and they are the most effective treatment for such climacteric symptoms as hot flushes , sweating , vaginal dryness , and dyspareunia .
The combination of a SERM with estrogen as a tissue selective estrogen complex ( TSEC ) is a new strategy for the prevention of bone loss and the treatment of climacteric symptoms .
This combination is particularly interesting from a clinical point of view , taking into account that estrogen alone did not increase breast cancer risk by the Women 's Health Initiative .
TSEC is hypothesized to provide the benefits of estrogen-alone therapy , with an improved tolerability profile because the SERM component can make possible the elimination of progestin .
The conclusion is that effectively , the combination of bazedoxifene and conjugated estrogens may be a promising alternative to hormone therapy for the prevention of osteoporosis and the treatment of postmenopausal symptoms in non-hysterectomized postmenopausal women
Decreasing levels of estrogens during menopause are associated with reduced bone density and an increased risk of osteoporosis .
Many women also experience bothersome vasomotor and vaginal symptoms during the menopausal transition .
Unfortunately , estrogen therapy and hormone therapy increase the risk of endometrial and breast cancer , respectively .
The selective estrogen receptor modulators ( SERMs ) result in positive estrogenic effects on bone , with no negative effects on the endometrium and breast but do not provide relief from postmenopausal symptoms .
The objective of this review was to critically evaluate the evidence from the reports published to date on the use of bazedoxifene ( a third-generation SERM ) in combination with conjugated estrogens in postmenopausal women .
Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial.
UNLABELLED We used data from the Fracture Intervention Trial to assess the relationship change in bone turnover after 1 year of alendronate or placebo treatment and subsequent hip , non-spine , and spine fracture risk among 6186 postmenopausal women . In the alendronate group ( n = 3105 ) , greater reductions in one or more biochemical marker were associated with a lower risk of fracture . INTRODUCTION There are few data on the relationship between short-term change in biochemical markers of bone turnover and non-spine fracture risk among bisphosphonate-treated women , and the clinical use of such measurements is unknown . MATERIAL S AND METHODS We measured biochemical markers of bone turnover ( bone-specific alkaline phosphatase [ bone ALP ] , intact N-terminal propeptide of type I collagen , and C-terminal crosslinked telopeptide of type 1 collagen ) and BMD of the spine and hip at baseline and after 1 year of alendronate or placebo . During a mean follow-up of 3.6 years , 72 hip , 786 non-spine , and 336 vertebral fractures were documented . RESULTS AND CONCLUSIONS Each 1 SD reduction in 1-year change in bone ALP was associated with fewer spine ( odds ratio = 0.74 ; CI : 0.63 , 0.87 ) , non-spine ( relative hazard [ RH ] = 0.89 ; CI : 0.78 , 1.00 ; p < 0.050 ) , and hip fractures ( RH = 0.61 ; CI : 0.46 , 0.78 ) . Alendronate-treated women with at least a 30 % reduction in bone ALP had a lower risk of non-spine ( RH = 0.72 ; CI : 0.55 , 0.92 ) and hip fractures ( RH = 0.26 ; CI : 0.08 , 0.83 ) relative to those with reductions < 30 % . We conclude that greater reductions in bone turnover with alendronate therapy are associated with fewer hip , non-spine , and vertebral fractures , and the effect is at least as strong as that observed with 1-year change in BMD
Results of systematic review s and meta-analyses of r and omized controlled trials have shown that both systemic estrogen therapy or hormone therapy ( estrogen combined with a progestin ) are useful to prevent bone loss , and they are the most effective treatment for such climacteric symptoms as hot flushes , sweating , vaginal dryness , and dyspareunia .
The combination of a SERM with estrogen as a tissue selective estrogen complex ( TSEC ) is a new strategy for the prevention of bone loss and the treatment of climacteric symptoms .
This combination is particularly interesting from a clinical point of view , taking into account that estrogen alone did not increase breast cancer risk by the Women 's Health Initiative .
TSEC is hypothesized to provide the benefits of estrogen-alone therapy , with an improved tolerability profile because the SERM component can make possible the elimination of progestin .
The conclusion is that effectively , the combination of bazedoxifene and conjugated estrogens may be a promising alternative to hormone therapy for the prevention of osteoporosis and the treatment of postmenopausal symptoms in non-hysterectomized postmenopausal women
Decreasing levels of estrogens during menopause are associated with reduced bone density and an increased risk of osteoporosis .
Many women also experience bothersome vasomotor and vaginal symptoms during the menopausal transition .
Unfortunately , estrogen therapy and hormone therapy increase the risk of endometrial and breast cancer , respectively .
The selective estrogen receptor modulators ( SERMs ) result in positive estrogenic effects on bone , with no negative effects on the endometrium and breast but do not provide relief from postmenopausal symptoms .
The objective of this review was to critically evaluate the evidence from the reports published to date on the use of bazedoxifene ( a third-generation SERM ) in combination with conjugated estrogens in postmenopausal women .