The author and author's affiliation should be corrected.
Bone Density* ; Endometriosis* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Raloxifene Hydrochloride*

Osteoporosis becomes a serious health threat for aging postmenopausal women by predisposing them to an increased risk of fracture. Conventional pharmacological options are available for osteoporosis therapy, including bisphosphonates, the SERM raloxifene, estrogens, clacitonin, and parathyroid hormone. Although alternative treatment regimens, such as phytoestrogens, herbals, and dehydroepiandrosterone (DHEA) also show beneficial effect on bone density and health, further study to determine optional formulation is needed. Several new drugs are available or are in clinical development.
Aging ; Bone Density ; Dehydroepiandrosterone ; Diphosphonates ; Estrogens ; Female ; Humans ; Osteoporosis ; Parathyroid Hormone ; Phytoestrogens ; Raloxifene ; Selective Estrogen Receptor Modulators ; Raloxifene Hydrochloride

OBJECTIVES: Breast density is an independent risk factor for the development of invasive breast cancer. We conducted this study to evaluate the effects of 3 years of hormone therapy, raloxifene, and alendronate on mammographic breast density in postmenopausal Korean women. METHODS: We studied 127 postmenopausal women who had visited the Department of Obstetrics and Gynecology of Inje University Sanggye Paik Hospital between January 2000 and June 2010. These patients were divided into the following 5 groups: alendronate (n = 26); raloxifene (n = 18); estrogen therapy (ET; n = 43); continuous estrogen-progesterone therapy (EPT; n = 20); and cyclic EPT (n = 20). The Breast Image Reporting and Data System (BI-RADS) composition grade 1, 2, and 3 years after treatment was compared with the BI-RADS composition grade at baseline. RESULTS: The BI-RADS grade decreased significantly in the raloxifene group at 1 year (P = 0.04). The BI-RADS grade increased significantly in the ET group at 3 years (P = 0.03), in the continuous EPT at 1, 2, and 3 years (P = 0.01, < 0.001, < 0.001, respectively), and in the cyclic EPT group at 2 and 3 years (P = 0.04 and 0.02, respectively). Although not statistically significant, a decrease in the BI-RADS grade occurred in the alendronate group at 1, 2, and 3 years (P = 0.08, 0.1, and 0.1, respectively). CONCLUSION: This study showed that there was significant decrease in mammographic breast density at 1 year in the raloxifene group and a decreasing trend in the alendronate group, whereas there was significant increase in the ET and EPT groups. To determine the effect of raloxifene and alendronate on breast density, larger prospective studies are needed.
Alendronate ; Breast ; Breast Neoplasms ; Estrogens ; Female ; Gynecology ; Humans ; Information Systems ; Menopause ; Obstetrics ; Raloxifene Hydrochloride ; Risk Factors

BACKGROUND: Epidemiology studies suggest that oral bisphosphonate may increase the risk of esophageal cancer. The present study aimed to investigate the association between exposure of oral bisphosphonate and risk of esophageal cancer. METHODS: Using the nationwide medical claim database in South Korea, 2,167,955 subjects, who initiated osteoporosis treatment (oral bisphosphonate, intravenous bisphosphonate or raloxifene) or performed dual energy X-ray absorptiometry (DXA) between 2008 and 2012, were analyzed. Diagnosis of esophageal cancer was estimated from medical claim database. Standardized incidence ratio (SIR) was estimated by comparing with incidence in the general population. Cox proportional hazards modeling was used to investigate age-adjusted hazard ratio (aHR) of esophageal cancer. RESULTS: The present study included oral bisphosphonate group (N=1,435,846), comparator group 1 (intravenous bisphosphonate or raloxifene, N=78,363) and comparator group 2 (DXA, N=653,746). Mean age was 65.6+/-8.8 years and mean observation duration was 30.9+/-17.7 months. During 5,503,688 patient-years, 205 esophageal cancer incidences were observed. The annual incidence of esophageal cancer was 3.88, 4.21, and 3.30 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. SIR of esophageal cancer was 1.24, 1.38, and 1.40 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. Esophageal cancer risk of oral bisphosphonate group was not significantly different from comparator group 1 and comparator group 2 (aHR 0.87; 95% confidence interval [CI] 0.39-1.98 and aHR 0.94; 95% CI 0.68-1.30, respectively). CONCLUSIONS: The use of oral bisphosphonate was not associated with increased risk of esophageal cancer in real clinical practice using large scale nationwide database.
Absorptiometry, Photon ; Diagnosis ; Epidemiology ; Esophageal Neoplasms* ; Incidence ; Korea ; Osteoporosis ; Proportional Hazards Models ; Raloxifene Hydrochloride

OBJECTIVES: Osteoporosis is the most common chronic skeletal disease in postmenopausal women. The total sales of anti-osteoporosis medications have rapidly increased in Korea in recent years because of the rapid aging of our society. This study was intended to evaluate the trend in the use of anti-osteoporosis medications in 2009. METHODS: Data from the International Marketing Service (IMS) were used to analyze the sales of medications for osteoporosis. The total sales of anti-osteoporosis medications were considered to correspond to the use of anti-osteoporosis medications. RESULTS: The total market of anti-osteoporosis medications including hormones and calcium was 213.9 billion Korea won (KRW). The proportion of anti-osteoporosis medications accounted for by hormones and calcium was 16% and 84%, respectively. The total consumption of calcium was 26.9 billion KRW and nearly all the sales were over-the-counter products. Total hormone consumption was 35.6 billion KRW, of which tibolone comprised 41%. Bisphosphonate consumption was 129.6 billion KRW; the proportion of bisphosphonates in non-hormonal medications was 85.6%, followed in order by vitamin D (6.9%), raloxifene (5.0%), and calcitonin (2.0%). CONCLUSION: The most commonly used anti-osteoporosis medications based on sales were bisphosphonates comprising 60.6% of the total sales, followed by hormones and vitamin D.
Aging ; Calcitonin ; Calcium ; Commerce ; Diphosphonates ; Female ; Humans ; Korea ; Marketing ; Norpregnenes ; Osteoporosis ; Raloxifene Hydrochloride ; Vitamin D

BACKGROUND: Osteoporosis and its associated fractures have become increasingly common in Korea because of increasing population age. Both alendronate (ALN) and raloxifene (RLX) can treat and prevent new vertebral fractures. The purpose of this study was to compare the effects of combined alendronate and raloxifene therapy with alendronate therapy alone in osteoporotic patients that had been treated by percutaneous vertebroplasty. METHODS: We analyzed 40 patients older than 50 years, and performed percutaneous vertebroplasty due to osteoporotic compression fractures. Twenty patients received alendronate only at 70 microgram/week, and the other 20 patients received combined alendronate at 70 microgram/week and raloxifene at 60 microgram/day. At baseline and after 3 and 6 months, we measured the bone mineral density (BMD) of the lumbar spine and femoral neck. RESULTS: On average, the lumbar spine BMD increased by 7.1 and 8.7% from baseline in the ALN and in the ALN + RLX group. The increase in femoral neck BMD in the ALN + RLX group (8.0%) was greater than the 5.6% increase in the ALN group (P = 0.02). CONCLUSIONS: Combined RLX and ALN therapy is more effective than ALN therapy alone in terms of increasing the femoral neck BMD in osteoporotic vertebral compression fracture patients treated by percutaneous vertebroplasty.
Alendronate ; Bone Density* ; Femur Neck ; Fractures, Compression ; Humans ; Korea ; Osteoporosis ; Raloxifene Hydrochloride ; Spine* ; Vertebroplasty*

Osteoporosis is a common and significant health problem in more than 1/3 of postmenopausal women. Strategies for the medical treatment of osteoporosis are primarily based on decreasing the resorption component of bone turnover by estrogen, alendronate, risedronate, raloxifene, or calcitonine. Recently there are therapies that are focused on increasing bone formation by fluoride, parathyroid hormone, or strontium ranelate. This article reviews the medical treatment of osteoporosis focusing on the pharmacokinetic effects on the bone metabolism, anti-fracture effects, usage of the drugs and their side effects.
Alendronate ; Calcitonin ; Estrogens ; Female ; Fluorides ; Humans ; Metabolism ; Osteogenesis ; Osteoporosis* ; Parathyroid Hormone ; Raloxifene Hydrochloride ; Risedronate Sodium ; Strontium

Osteoporosis is a common and significant health problem in more than 1/3 of postmenopausal women. Strategies for the medical treatment of osteoporosis are primarily based on decreasing the resorption component of bone turnover by estrogen, alendronate, risedronate, raloxifene, or calcitonine. Recently there are therapies that are focused on increasing bone formation by fluoride, parathyroid hormone, or strontium ranelate. This article reviews the medical treatment of osteoporosis focusing on the pharmacokinetic effects on the bone metabolism, anti-fracture effects, usage of the drugs and their side effects.
Alendronate ; Calcitonin ; Estrogens ; Female ; Fluorides ; Humans ; Metabolism ; Osteogenesis ; Osteoporosis* ; Parathyroid Hormone ; Raloxifene Hydrochloride ; Risedronate Sodium ; Strontium

OBJECTIVE: Postmenopausal osteoporosis is a common skeletal disease with serious consequences due to fracture, leading to increased morbidity and mortality. This study was carried out to evaluate the changes of national osteoporosis markets during the last 5 years and to estimate the trends of national osteoporosis market in the future. METHODS: The use of the medications for osteoporosis treatment was evaluated in terms of sales of drugs for osteoporosis treatment. The sales audit of drugs for osteoporosis treatment from Intercontinental Marketing Services (IMS) were used to analyse the sales of specific drugs. RESULTS: The total national osteoporosis market has been increased progressively and markedly during the last 5 years and was valued at 167.4 billion Korean won (KRW) in 2008. The use of hormone therapy was decreased markedly by 40% after reporting of WHI results and the reduction of hormone therapy has been continuing during the recent 5 years. The market size of the non-hormonal osteoporosis drugs has been grown by 73% during the last 5 years and was valued at 134.5 billion KRW in 2008. This non-hormonal drug market was dominated by bisphosphonates. which account for over 80% of total sales. The use of bisphosphonates and active vitamin D metabolites has been increasing but raloxifene and calcitonin, decreasing. CONCLUSION: The survery of recent national osteoporosis market using IMS sales audit showed that the use of drugs for osteoporosis treatment has been markedlly increasing during last 5 years from 2004 to 2008. This has been attributed to non-horomonal pharmacological drugs, especially bisphosphonate.
Calcitonin ; Commerce ; Diphosphonates ; Female ; Humans ; Korea ; Marketing ; Osteoporosis ; Osteoporosis, Postmenopausal ; Raloxifene Hydrochloride ; Vitamin D

OBJECTIVES: To evaluate and compare the efficacy and safety of the combination of raloxifene and alendronate with those of monotherapies in elderly women with osteoporosis. METHODS: Sixty-two postmenopausal women (mean age 63.5 ± 0.5 years) attending gynecologic osteoporosis clinics with established osteoporosis were randomly allocated to one of four treatment groups and monitored for 3 years. All patients enrolled in this study, including those in the control group (n = 14), received 1.0 g elemental calcium and 400 units of vitamin D per day. The raloxifene group (n = 16) received raloxifene 60 mg (Evista®) per day; alendronate group (n = 17) received low-dose (5 mg) alendronate with calcitriol 0.5 µg (Maxmarvil®) per day; and the combination therapy group (n = 15) received both raloxifene 60 mg and low-dose (5 mg) alendronate with calcitriol 0.5 µg. Bone mineral density (BMD) was measured in the lumbar spine and hip before and after 3 years of treatment. RESULTS: In patients who received the combined therapy, BMD increased in the lumbar spine and the hip by 7.2% (P<0.001) and 4.8% (P<0.001) at 3 years. For patients in the alendronate group, the increases were 6.7% (P<0.001) and 3.1% (P<0.01) respectively, for the raloxifene group, the increases were 4.36% (P<0.001) and 1.9% (P<0.05) in the vertebrae and femora, respectively; however, the BMD of patients in the control group decreased by 1.81% (P<0.05) and 1.6% (P<0.05), respectively, after 3 years. Patients who received the combination therapy had significantly higher BMD in both the vertebrae femora (P<0.01) in comparison to that in those treated with raloxifene or alendronate individually. CONCLUSIONS: This 3-year randomized study showed the improved effects of alendronate and raloxifene combination on spine and hip BMD in elderly postmenopausal women with established osteoporosis.
Aged* ; Alendronate* ; Bone Density ; Calcitriol ; Calcium ; Female ; Hip ; Humans ; Osteoporosis* ; Raloxifene Hydrochloride* ; Spine ; Vitamin D