EVISTA - (Raloxifene) in the news

Evista is one of a class of drugs known as selective estrogen receptor modulators or SERMs that includes the drug Tamoxifen given to women at high risk for breast cancer. As often happens in modern medicine, a drug prescribed for a certain purpose shows risks and benefits in unexpected ways. In the late 1980s researchers noticed that women taking Tamoxifen had increased bone density.

Since then the SERM raloxifene (Evista) has been developed as a treatment for osteoporosis and has been found to reduce the risk of vertebral but not hip fractures in high risk women. Tamoxifen increases risks for clotting and uterine cancer and Evista carries a threefold increased risk for clotting – similar to that found with HRT.

Now in a kind of reversal, a large NIH sponsored study (the STAR trial) of 19,747 women at high risk of getting breast cancer, has found Evista helps prevents breast cancer, has fewer side effects and resulted in fewer cases of uterine cancer than Tamoxifen. Overall Evista was found to be an equally effective and safer option for breast cancer treatment than Tamoxifen.

But wait, there’s more…

A simultaneous trial called the RUTH trial, a large-scale placebo-controlled study conducted by Evista’s producer Eli Lilly, investigated whether Evista would reduce the risk of coronary events and the risk of invasive breast cancer in 10,000 women with known heart disease or at high risk for a coronary event. Results showed there were fewer cases of breast cancer but that there was no protection from heart disease or stroke. Evista actually demonstrated an increase in mortality due to stroke compared to placebo.

On April 18 2006 Eli Lilly Canada advised that Evista is not indicated and should not be prescribed for the prevention or reduction of the risk of cardiovascular disease. They maintain that the benefit/risk profile remains favorable for the majority of patients taking Evista for osteoporosis treatment and prevention.

Then in complete contradiction…

On May 26 2006 Reuter’s Health distributed an article citing a small Turkish study of 43 postmenopausal women reported in the American Journal of Obstetrics and Gynecology. The researchers have found that raloxifene ‘decreased hyperactivity in the sympathetic nervous system’ and conclude that because activation of the sympathetic nervous system is associated with cardiovascular disease, Evista treatment may have in fact have a positive effect on cardiovascular health.

Who can blame women for being confused? It does all sound rather familiar doesn’t it. These were precisely the types of contradictory studies and statements made about HRT over all those years, until the truth finally came out.