Long-term safety and efficacy of raloxifene in the prevention and treatment of postmenopausal osteoporosis: An update

Enrico M. Messalli, Cono Scaffa

Research output: Contribution to journalArticlepeer-review


The integrity of bone tissue and its remodeling that occurs throughout life requires a coordinated activity of osteoblasts and osteoclasts. The decreased estrogen circulating level during postmenopausal transition, with a prevalence of osteoclastic activity over osteoblastic activity, represents the main cause of bone loss and osteoporosis. Osteoporosis is a chronic disease requiring long-term therapy and it is important to evaluate the effi cacy and safety of treatments over several years, as the fear of health risks is a common reason for discontinuing therapy. Raloxifene is a selective estrogen receptor modulator (SERM) leading to estrogen-agonist effects in some tissues and estrogen-antagonist effects in others. Raloxifene is effective to prevent and treat postmenopausal vertebral osteoporosis, with reduction of spine fractures and, in post-hoc analyses, non-spine fractures in high-risk subjects. Moreover, raloxifene reduces the risk of invasive breast cancer and improves the levels of serum lipoprotein but with an increased risk of venous thromboembolism and fatal stroke, without signifi cant change in the incidence of coronary events. For these reasons the overall risk-benefi t profi le is favorable. Therefore, when considering the use of raloxifene in a postmenopausal woman, we should take into account the osteoporosis-related individual risk and weigh the potential benefi ts, skeletal and extra-skeletal, against the health risks.

Original languageEnglish
Pages (from-to)11-20
Number of pages10
JournalInternational Journal of Women's Health
Issue number1
Publication statusPublished - 2009


  • Menopause
  • Osteoporosis
  • Raloxifene

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Maternity and Midwifery


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