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Osteoporosis Drug a Better HRT?

Evista Offers Promise of Disease Prevention for Older Women

Could Provide 'Widespread' Protection

The Raloxifene Use for the Heart (RUTH) trial, which includes just over 10,000 women in 26 countries who are at risk for heart disease, is designed to determine whether the SERM lowers the risk of coronary events and reduces the risk of breast cancer.

Principal investigator Lori Mosca, MD, PhD, tells WebMD that definitive findings should be published within five years. Mosca is a spokeswoman for the American Heart Association and director of preventive cardiology at New York Presbyterian Hospital.

"This drug has the potential for very widespread utilization in postmenopausal women, because the conditions that it would impact -- heart disease, breast cancer, and osteoporosis -- are major health concerns," she says.

So is Evista the disease-prevention panacea for older women that the hormone replacement therapy Prempro was once thought to be? All agree that it is way too early to say. While Evista does not appear to promote endometrial cancer like tamoxifen does, its use is associated with a small risk in blood clots in the leg. And it can actually worsen hot flashes in menopausal women, especially in those closest to the onset on menopause.

"We thought we had a good preventive drug with hormone replacement therapy, but we now know that this is not true," Jordan tells WebMD. "Tamoxifen is good for the treatment of breast cancer, but it doesn't have the right safety profile to give to everyone. The hope is that Evista has a better safety profile and protects against heart attack, bone loss, and breast cancer."

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