Evista® (Raloxifene Hydrochloride) the Evista® Term Paper

Therapy was discontinued due to an adverse event in 11% of EVISTA®-treated women and 9% of placebo-treated women. Common adverse events related to EVISTA® therapy were hot flashes and leg cramps. Hot flashes were most commonly reported during the first 6 months of treatment and were not different from placebo thereafter.

DRUG INTERACTIONS

Cholestyramine causes a 60% reduction in the absorption and enterohepatic cycling of raloxifene after a single dose. Thus, co-administration of cholestyramine with EVISTA® is not recommended.

COMPARATIVE EFFICACY

Overall, raloxifene exerts similar positive on bone mineral density and bone turnover as other SERMS and estrogen therapy. However, the reduction in fracture risk is improved with SERMs vs. estrogen (Nakamura 632).

COST ANALYSIS

Overall, administration of calcium and vitamin D is more effective and economical than any approved drug for postmenopausal osteoporosis. The annual cost of calcium and vitamin D treatment is $22 compared to $255 for estrogen, $696 for alendronate, and $723 for raloxifene. Furthermore, annualized bone mineral density is preserved to a greater extent with calcium and vitamin D at 1% vs. 0.8% with alendronate, 0.5% with estrogen, and 0.7% with raloxifene. However, in comparison to no treatment, raloxifene is a cost-effective osteoporosis treatment (Borgstrom et al. 1153).

PERSONAL PERSPECTIVE of EVISTA

Overwhelming evidence exists that EVISTA® is a safe and efficacious drug used to prevent and treat osteoporosis in postmenopausal women. The safety profile of this medication is favorable compared to estrogen because of the selective effects on the estrogen receptor. Although effects on bone mineral density are modest, EVISTA® substantially reduces fracture risk. Overall, EVISTA® should be recommended by primary care physicians to their patients who have or are at risk for osteoporosis and who have no contraindications to its use.

References

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Borgstrom, F., et al. "Cost Effectiveness of Raloxifene in the Treatment of Osteoporosis in Sweden: An Economic Evaluation Based on the More Study." Pharmacoeconomics 22.17 (2004): 1153-65.

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Cranney, a., et al. "Meta-Analyses of Therapies for Postmenopausal Osteoporosis. Iv. Meta-Analysis of Raloxifene for the Prevention and Treatment of Postmenopausal Osteoporosis." Endocr Rev 23.4 (2002): 524-8.

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Nakamura, T. "[Bone.....