Review of Comparative Effectiveness of Treatments to Prevent Fractures
Authors: John L. Stock, John L. Mershon, Michael Jay Schoenfeld
Journal: Annals of Internal Medicine (2008)

Letters3 June 2008Review of Comparative Effectiveness of Treatments to Prevent FracturesJohn L. Stock, MD, John L. Mershon, MD, and Michael Jay Schoenfeld, MAJohn L. Stock, MDFrom Eli Lilly and Company, Indianapolis, IN 46285.Search for more papers by this author, John L. Mershon, MDFrom Eli Lilly and Company, Indianapolis, IN 46285.Search for more papers by this author, and Michael Jay Schoenfeld, MAFrom Eli Lilly and Company, Indianapolis, IN 46285.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-11-200806030-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the recent comprehensive systematic review on osteoporosis therapies by MacLean and colleagues (1), and we would like to bring 3 issues to your attention.The article describes an increased risk for “mild cardiac events” with raloxifene, based on a combination of 4 events (tachycardia, chest pain, palpitations, and vasodilatation) across 6 studies (n = 2686). Criteria for selecting these particular events and trials are not given. The trials selected do not include pivotal randomized, placebo-controlled trials, such as the MORE (Multiple Outcomes of Raloxifene Evaluation, n = 7705) (2) and RUTH (Raloxifene Use for the ...References1. MacLean C, Newberry S, Maglione M, McMahon M, Ranganath V, Suttorp M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008;148:197-213. [PMID: 18087050] LinkGoogle Scholar2. Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282:637-45. [PMID: 10517716] CrossrefMedlineGoogle Scholar3. Barrett-Connor E, Mosca L, Collins P, Geiger MJ, Grady D, Kornitzer M, et al; Raloxifene Use for The Heart (RUTH) Trial Investigators. Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women. N Engl J Med. 2006;355:125-37. [PMID: 16837676] CrossrefMedlineGoogle Scholar4. Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS, Atkins JN, et al. National Surgical Adjuvant Breast and Bowel Project (NSABP). Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA. 2006;295:2727-41. [PMID: 16754727] CrossrefMedlineGoogle Scholar5. Saag KG, Shane E, Boonen S, Marín F, Donley DW, Taylor KA, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med. 2007;357:2028-39. [PMID: 18003959] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Eli Lilly and Company, Indianapolis, IN 46285.Disclosures:Employment: J.L. Stock, J.L. Mershon, M.J. Schoenfeld (Eli Lilly and Company). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis Catherine MacLean , Sydne Newberry , Margaret Maglione , Maureen McMahon , Veena Ranganath , Marika Suttorp , Walter Mojica , Martha Timmer , Alicia Alexander , Melissa McNamara , Sheetal B. Desai , Annie Zhou , Susan Chen , Jason Carter , Carlo Tringale , Di Valentine , Breanne Johnsen , and Jennifer Grossman Review of Comparative Effectiveness of Treatments to Prevent Fractures Dennis M. Black , Steven Boonen , Pierre Delmas , and Kenneth W. Lyles Review of Comparative Effectiveness of Treatments to Prevent Fractures Robert Karis Review of Comparative Effectiveness of Treatments to Prevent Fractures Catherine MacLean , Margaret Maglione , and Marika Suttorp Review of Comparative Effectiveness of Treatments to Prevent Fractures Harold Rosen Review of Comparative Effectiveness of Treatments to Prevent Fractures Lionel S. Lim Metrics 3 June 2008Volume 148, Issue 11Page: 885KeywordsBreast cancerDrug administrationHeartIschemiaOsteoporosisSafetySpineSystematic reviewsTachycardiaVasodilation ePublished: 3 June 2008 Issue Published: 3 June 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...