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Re: EvistaFrom: Braun, R. Daniel (rbraun@iupui.edu)Mon Nov 29 12:19:30 2004
But shouldn't the premenopausal patients estrogen do everything that raloxiphene does for the bone? R. Daniel Braun, MD "If everyone likes you, you're doing something wrong." Kinky Friedman I believe a self-righteous liberal or conservative with a cause is more dangerous than a Hell's Angel with an attitude. Andy Rooney -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Douglas Krell Sent: Monday, November 29, 2004 12:59 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Evista Richard, Ana et al..., While there are no indications for the use of Evista in premenopausal women (raloxifene competes with endogenous estrogen for estrogen receptor binding sites), the use of raloxifene for the treatment of osteopenia in postmenopausal women is an important strategy in the scheme of the ultimate goal of preventing fractures in women due to bone loss . The National Osteoporosis Foundation as well the International Osteoporosis Foundation recommends treatment with raloxifiene for women with demonstrated osteopenia when there are two additional risk factors for osteoporosis present; Family history, caucasian, smoking, low calcium intake, body weight under 125lbs....just about all of our patients. These recommendations are published on their web sites The NORA (National Osteoporosis Risk Assessment) trial recently published with over 200,000 women studied in outpatient settings found that of the women who sufferred a fracture, over 80% had OSTEOPENIA...not osteoporosis. So there is some reason to consider treating these women. Moreover, raloxifiene is the only therapy I'm aware of that has been proven to prevent fracture in randomized, doubly blinded trials when studied prospectively in the patient with osteopenia. Everyone else has only BMD data. Douglas Krell MD FACOG
>From: "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>
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