A study appearing in the July 2008 issue of
the Journal of the American Society Nephrology has advocated the use of
osteoporosis drug raloxifene even in the presence of chronic kidney disease.
The findings indicate that raloxifene is
safe and effective for women with CKD, a patient population often excluded from studies of osteoporosis drugs.
Because CKD may lead to metabolic
abnormalities that accelerate bone loss, it is important to monitor bone
mineral density levels in these patients and to administer treatments when
levels are low. However, the use of osteoporosis therapies for patients with
this disease is highly controversial, given the drugs' previously unknown
effectiveness and safety in these individuals.
To determine whether raloxifene is a
suitable treatment option for women with CKD, Dr. Areef Ishani, of the
Minneapolis VA Medical Center and University
of Minnesota, in Minneapolis, MN,
and his colleagues analyzed data from the Multiple Outcomes of Raloxifene
Evaluation (MORE), a multi-center, randomized, placebo-controlled trial of
7,705 postmenopausal women with osteoporosis. They examined the effect of
raloxifene over three years on the rate of change of bone mineral density,
incidence of fractures, and adverse effects in women with and without CKD.
The investigators found that irrespective
of kidney function, patients taking raloxifene experienced a greater increase
in spine bone mineral density and a reduction in vertebral fractures compared
with patients taking a placebo. Raloxifene also increased hip bone mineral
density, most prominently in women with mild to moderate CKD.
The study's results have significant
clinical relevance because many postmenopausal women have unidentified CKD. The
findings are reassuring in that raloxifene can safely be used in women who have
decreased kidney function.
The study, entitled, "The Effect of
Raloxifene Treatment in Postmenopausal Women with CKD," will be available
online at http://jasn.asnjournals.org/ beginning on Wednesday, April 9, 2008,
and coincides with Osteoporosis Awareness Month in May and National Women's
Health Week from May 11-17.
Dr. Ishani's research will help physicians
provide better care for women, specifically by providing information that will
allow them to safely and effectively treat more women who have or are at risk
for osteoporosis. Women can also now feel confident that decreased kidney
function will not keep them from getting effective osteoporosis care. National
Women's Health Week initiatives encourage women to make their health a top
priority and take steps for a longer, healthier, and happier life. These
include engaging in physical activity, eating a nutritious diet, and scheduling
preventive health screenings, such as bone density tests.