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首页> 外文期刊>International journal of clinical rheumatology. >The PEARL trial: lasofoxifene and incidence of fractures,breast cancer and cardiovascular events in postmenopausal osteoporotic women
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The PEARL trial: lasofoxifene and incidence of fractures,breast cancer and cardiovascular events in postmenopausal osteoporotic women

机译：PEARL试验：拉莫昔芬与绝经后骨质疏松妇女的骨折，乳腺癌和心血管事件发生率

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Selective Estrogen-Receptor Modulators (SERMs) are a class of compounds that act on the estrogen receptors (ERs). Lasofoxifene is a nonsteroidal-selective ER modulator that decreases bone rea-sorption, bone loss and low density lipoprotein (LDL) cholesterol in postmenopausal women [1]. Lasofoxifene appears to represent an advance in the progression of pharmacological agents at our disposal, which can reduce both the risk of fractures in women with osteoporosis and the risk of breast cancer in postmenopausal women [2-4], possibly because it binds with high affinity to both ER-a and ER-p. Previous randomized trials of tamoxifen in postmenopausal women with breast cancer [5] and trials of raloxifene [6,7] and lasofoxifene [l] in healthy postmenopausal women have found favorable changes in lipid levels with treatment. In one study, prevention of bone loss in postmenopausal women treated with lasofoxifene compared with raloxifene has been tested. The two doses of lasofoxifene (0.25 mg/day and 1.0 mg/day) and 60 mg/day of raloxifene were equally effective at increasing total hip BMD, which was reflected in a low risk of hip fractures. Compared to raloxifene, lasofoxifene at 2 years produced greater increases of 1.9% (0.4, 3.4) and 2.3% (0.9,3.6) in lumbar spine BMD, respectively (p < 0.05). They significantly reduced the levels of biochemical markers of bone turnover compared with placebo where the effects of lasofoxifene swere greater then the response to raloxifene [8].
机译：选择性雌激素受体调节剂（SERM）是一类作用于雌激素受体（ER）的化合物。拉索昔芬是一种非甾体选择性的ER调节剂，可降低绝经后妇女的骨吸收，骨丢失和低密度脂蛋白（LDL）胆固醇[1]。拉索昔芬似乎代表了我们可以使用的药理学进展的一项进步，既可以降低骨质疏松症妇女的骨折风险，也可以降低绝经后妇女的乳腺癌风险[2-4]，这可能是因为它具有高亲和力对ER-a和ER-p而言。先前的他莫昔芬在绝经后乳腺癌患者中的随机试验[5]以及雷洛昔芬[6,7]和拉索昔芬[l]在健康的绝经后妇女中的试验发现，治疗后血脂水平出现了有利的变化。在一项研究中，已经测试了与雷洛昔芬相比，用拉索昔芬治疗的绝经后妇女的骨质流失预防。两种剂量的拉索昔芬（0.25 mg /天和1.0 mg /天）和60 mg /天的雷洛昔芬在增加总髋部BMD方面同样有效，这反映出髋部骨折的风险较低。与雷洛昔芬相比，拉索昔芬在2年时的腰椎BMD分别增加了1.9％（0.4，3.4）和2.3％（0.9,3.6）（p <0.05）。与安慰剂相比，他们显着降低了骨转换的生化标志物水平，在安慰剂中，拉索昔芬的作用比对雷洛昔芬的反应要大[8]。

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