Evista aids bone health in lupus patients

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A small study has shown that the osteoporosis drug raloxifene, sold as Evista, helps maintain bone mineral density (BMD) in menopausal women with systemic lupus erythematosus (SLE) who are on corticosteroids.

SLE is a chronic autoimmune disease in which the immune system can confuse healthy and foreign tissues and sometimes attacks both. The disorder disproportionately affects women. SLE may be treated with steroids and long-term treatment with steroids can result in bone-thinning.

Dr. Chi Chiu Mok of Tuen Mun Hospital in Hong Kong and colleagues randomized 33 women with osteopenia—a bone-thinning condition just short of osteoporosis—and inactive SLE to treatment with either 60 milligrams of raloxifene daily plus 1,200 milligrams of calcium or to calcium only. All of the women were taking low-doses of the steroid prednisolone.

At 1 year, women on calcium alone showed a 2.6 percent reduction in BMD at the femoral neck—the area where thigh bone meets the hip—and a 3.3 percent reduction in BMD in the lower spine. In contrast, there was no change in BMD in the raloxifene group.

Four patients on raloxifene and six in the control group had mild to moderate lupus flares, which was not a significant difference, while none of the women in the study had severe flares.

Because lupus flares are rare in postmenopausal women, the researchers note, a much larger study would be needed to identify any effect of raloxifene on disease activity in this group. “Thus, close monitoring for disease flares is still necessary in SLE patients who are receiving raloxifene,” they write.

It’s also noteworthy, according to the team, that women on raloxifene also showed an increase in “good” HDL cholesterol levels and a decrease in “bad” LDL levels, which was not seen in the control group.

The current study and other recent findings, they write, suggest that raloxifene could help protect the heart in addition to treating osteoporosis. “Further multicenter double-blind placebo-controlled trials are necessary to reinforce our results,” they conclude.

SOURCE: Arthritis and Rheumatism, December 2005. 

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