Are There Alternatives to Bisphosphonates for Osteoporosis Prevention?
Raloxifene (Evista) is a drug that acts at the estrogen receptor and is touted as having the beneficial effects of estrogen for osteoporosis, without the increased risk of uterine and ovarian cancer. However, Evista has other side effects similar to estrogen, including increased blood clotting (Ettinger et al 1999). Like the bisphosphonates, Evista does increase bone mineral density and reduce risk of vertebral fracture in postmenopausal women. However, each year it saves only about one or two women out of 100 from a vertebral fracture. It has not been shown to prevent nonvertebral fractures. In the Multiple Outcomes of Raloxifene Evaluation (MOR) study, 7705 postmenopausal women with osteoporosis received raloxifene or placebo in a randomized placebo controlled trial (Ettinger et al 1999). Although Raloxifene decreased vertebral fractures and increased bone density, it did not decrease non-vertebral fractures. Also only 22 women out of 7705 were saved from a hip fracture, which transl
