December 29, 2005

Evista aids bone health in lupus patients

NEW YORK (Reuters Health) - A small study has shown that
the osteoporosis drug raloxifene, sold as Evista, helps
maintain bone mineral density (BMD) in menopausal women with
systemic lupus erythematosus (SLE) who are on corticosteroids.

SLE is a chronic autoimmune disease in which the immune
system can confuse healthy and foreign tissues and sometimes
attacks both. The disorder disproportionately affects women.
SLE may be treated with steroids and long-term treatment with
steroids can result in bone-thinning.

Dr. Chi Chiu Mok of Tuen Mun Hospital in Hong Kong and
colleagues randomized 33 women with osteopenia -- a
bone-thinning condition just short of osteoporosis -- and
inactive SLE to treatment with either 60 milligrams of
raloxifene daily plus 1,200 milligrams of calcium or to calcium
only. All of the women were taking low-doses of the steroid

At 1 year, women on calcium alone showed a 2.6 percent
reduction in BMD at the femoral neck -- the area where thigh
bone meets the hip -- and a 3.3 percent reduction in BMD in the
lower spine. In contrast, there was no change in BMD in the
raloxifene group.

Four patients on raloxifene and six in the control group
had mild to moderate lupus flares, which was not a significant
difference, while none of the women in the study had severe

Because lupus flares are rare in postmenopausal women, the
researchers note, a much larger study would be needed to
identify any effect of raloxifene on disease activity in this
group. "Thus, close monitoring for disease flares is still
necessary in SLE patients who are receiving raloxifene," they

It's also noteworthy, according to the team, that women on
raloxifene also showed an increase in "good" HDL cholesterol
levels and a decrease in "bad" LDL levels, which was not seen
in the control group.

The current study and other recent findings, they write,
suggest that raloxifene could help protect the heart in
addition to treating osteoporosis. "Further multicenter
double-blind placebo-controlled trials are necessary to
reinforce our results," they conclude.

SOURCE: Arthritis and Rheumatism, December 2005.