Doctors hail new drug for women

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The Independent Online
THE PROMISE of protection in a single pill against three of the major diseases of ageing was held out to women yesterday.

Doctors can barely contain their excitement about the drug, called raloxifene, which has initially been licensed for the prevention of bone fractures in women at risk of the bone-thinning disease osteoporosis. Early trials of the drug, launched in Britain yesterday, show that it also cuts the risk of breast cancer by 52 per cent and reduces cholesterol levels to give protection against heart disease.

Experts believe that if the drug lives up to its early promise, it could become a standard treatment offered to all women after hormone replacement therapy (HRT) has got them through the immediate symptoms of the menopause. Although many years of studies lie ahead before its value is confirmed, doctors are comparing its importance to the discovery of the anti-ulcer treatments such as Zantac, which became the biggest selling drugs of all time.

Raloxifene, whose brand name is Evista, is made by Eli Lilly and costs just over pounds 20 for a month's supply. It is the first of the selective oestrogen receptor modulators (Serms), refined versions of HRT with a selective action that work like oestrogen in some tissues but not in others.

It is a cousin of tamoxifen, the anti-breast cancer drug, and appears to combine the benefits of tamoxifen and HRT with none of their disadvantages - thickening of the lining of the womb associated with an increased risk of endometrial cancer in the case of tamoxifen, and a slight increase in breast cancer with long-term use of HRT.

Professor Ignac Fogelman, head of the department of nuclear medicine at Guy's Hospital, central London, and an expert on osteoporosis, said: "We have had many discussions about what type of woman [raloxifene] would be suitable for. We have to wait for the hard evidence. We already have the evidence in the case of spinal fractures [reduced by 40 to 50 per cent] and the cardiovascular evidence looks favourable. The breast cancer data is truly exciting ... But it is early days."

Professor David Purdie, chairman of the British Menopause Society and head of the centre for metabolic bone disease at Hull Royal Infirmary, said: "I don't see it as a substitute for HRT. Many women who complain of symptoms such as hot flushes or night sweats will continue to need HRT.

"But for older women whose menopausal symptoms have eased - that might be the time to introduce it. It represents a major advance in protecting a woman's long-term health during her post-menopausal years."

An estimated 2 million women are affected by osteoporosis in the United Kingdom, with one-quarter of those in their sixties and half in their seventies having suffered one or more fractures. One in three hospital beds in orthopaedic departments is occupied by women with fractures caused by osteoporosis, and the disease is estimated to cost the National Health Service pounds 1bn a year.

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