Estrogeny i SERMY w profilaktyce i leczeniu osteoporozy postmenopauzalnej

Sławomir Wołczyński¹, Karol Kita², Stanisław Sierakowski², Bogdan Lewandowski²

Streszczenie
Osteoporosis is a systemic skeletal disorder characterized by microarchitectural deterioration of bone tissue with a resultant increase of fragility. There is an increase risk of fractures, which may occur even without a significant trauma. Osteoporosis is a complication of menopause, because of bone loss due to estrogen deficiency as a main cause. Appropriate screening strategies and significant pharmacologic interventions are available to prevent and treat osteoporosis. Estrogens and raloxifene suppress bone remodeling to the premenopausal range, maintaining the function of osteoblasts and osteocytes. The WHI and HERS studies results demonstrated a significant reduction in fractures in women using hormone therapy, but the risk of cardiovascular events and breast cancer increased. The optimal time to initiate therapy and the optimal duration of therapy has not been determined. Generally, estrogen or hormone therapy is believed to work best if is started in the first 5 years after menopause. The MORE study has shown, that in postmenopausal women raloxifene significantly reduces bone resorption, increases bone mineral density and reduces vertebral fractures in women with established osteoporosis and decreased the risk of cardiovacular events and breast cancer.

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