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The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis

Year 2012, , 457 - 462, 01.12.2012
https://doi.org/10.5799/ahinjs.01.2012.04.0202

Abstract

Objectives: The aim of this study was to examine the effect of smoking on the efficacy of raloxifene treatment in postmenopausal osteoporosis. Materials and methods: In this cross-sectional study, raloxifene HCl (60 mg/day) and 600 mg ionized calcium + 400 IU vitamin D/day treatment were given to 63 cases (nonsmoker group n = 39, smoker group n = 24), who were in the postmenopausal period and detected as having osteoporosis. At the end of the first year of the treatment, the bone mineral densities (BMDs; g/cm2) were measured at four regions, namely the femur neck, femur trochanter, total hip, and lumbar vertebrae between L1-4, and T-scores were determined. The changes in BMDs were compared between the two groups. Results: Before starting the treatment, the mean ages (55.8 &plusmn; 3.3 vs. 53.0 &plusmn; 1.3 years), menopausal ages (49.3 &plusmn; 2.9 vs. 48.1 &plusmn; 2.1 years), postmenopausal periods (5.0 &plusmn; 1.3 vs. 7.0 &plusmn; 1.4 years), body mass indexes, and estradiol levels were found to be significantly not different between the two groups (p > 0.05). At the beginning of treatment, the BMD values were not different for all measured regions in both groups (p > 0.05). At the end of the first year of the treatment, statistically significant improvements in BMD values and T-scores were detected for all measured regions in the nonsmoker group (p < 0.05). However, there were no significant differences in the BMD values from the initial values in the smoker group after treatment (p > 0.05). Conclusions: The treatment efficacy of raloxifene in improving BMD values in postmenopausal osteoporosis is negatively influenced by smoking. J

References

  • Consensus Development Statement. Who are candi- dates for prevention and treatment for osteoporosis? Osteop Int 1997;7:1-6.
  • Reginster JY. Antifracture efficacy of currently available therapies for postmenopausal osteoporosis. Drugs 2011;71(1):65-78.
  • Cosman F. Selective estrogen-receptor modulators. Clin Geriatr Med 2003;19(2):371-9.
  • Cetinkaya Demir B, Uyar Y, Ozbilgin K, Köse C. Effect of raloxifene and atorvastatin in atherosclerotic pro- cess in ovariectomized rats. J Obstet Gynaecol Res 2012 Jul 29. doi: 10.1111/j.1447-0756.2012.01969.x.
  • Riggs BL, Hartmann LC. Selective estrogen-receptor modulators - mechanisms of action and application to clinical practice. N Engl J Med 2003;348(7):618-29.
  • Ettinger B, Black DM, Mitlak BH. Reduction of vertebral fracture risk in postmanopausal women with osteopo- rosis treated with raloxifene. JAMA 1999;282(7):637- 45.
  • Helga Hansdottir. Raloxifene for older women: a review of the literature .Clin Interv Aging 2008;3(1);45-50.
  • Delmas Pierre D, Ensrud K, Adachi J. Efficacy of raloxi- fene on vertebral fracture risk reduction in postmano- pausal women with osteoporosis: four-year results from a randomized clinical tria.j Clin Endocrinol Metab 2002;87(8):3609-17.
  • Holbrook TL, Barrett-Connor E, Wingard DL. Dietary calcium and risk of hip fracture. 14-year prospective population study. Lancet 1988;2(8619):1046-9.
  • Jensen GF.Osteoporosis of the slender smoker re- visited by epidemiologic approach. Eur J Clin Invest 1986;16(3):239-42.
  • Brook JS, Balka EB, Zhang C. The smoking patterns of women in their forties: their relationship to later os- teoporosis. Psychol Rep 2012;110(2):351-62.
  • Pinheiro MM, Reis Neto ET, Machado FS, Omura F, Yang JH, Szejnfeld J, Szejnfeld VL. Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women. Rev Saude Publica 2010;44(3):479-85.
  • McKinlay SM, Bifano NL, McKinlay JB. Smoking and age at manopause in women. Ann Intern Med 1985;103(3):350-56.
  • Dytfeld J, Ignaszak-Szczepaniak M, Gowin E. Influ- ence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis. Arch Gerontol Geriatr 2011;53(2):237-42.
  • El Hage R, Jacob C, Moussa E, Baddoura R. Relative importance of lean mass and fat mass on bone min- eral density in a group of Lebanese postmenopausal women. J Clin Densitom 2011;14(3):326-31.
  • Krall EA, Dawson-Hugues B. Smoking and bone loss among postmenopausal women. J Bone Miner Res 1991;6(4):331-8.
  • Krall EA, Dawson-Hugues B. Smoking increases bone loss and decreases intestinal calcium absorp- tion. J Bone Miner Res 1999;14(2):215-20.
  • Pereira RM, Carvalho JF, Paula AP, Zerbini C. Guide- lines for the prevention and treatment of glucocor- ticoid-induced osteoporosis. Rev Bras Reumatol 2012;52(4):580-93.
  • Mizrak S, Yurekli B, Yilmaz C, Ercan G, Turan V. The effect of long-term nicotine exposure on bone mineral density and oxidative stress in female Swiss Albino rats. Arch Gynecol Obstet.2012 doi : 10.1007/s00404- 012-2535-8
  • Barbieri RL, Gochberg J, Ryan KJJ. Nicotine, coti- nine, and anabasine inhibit aromatase in human tro- phoblast in vitro. Clin Invest 1986;77(6):1727-33.
  • Silverman SL, Christiansen C, Genant HK. Efficacy of bazedoxifene in reducing new vertebral fracture risk in postmenopausal women with osteoporosis: results from a 3-year, randomized, placebo-, and active-controlled clinical trial. J Bone Miner Res 2008;23(12):1923-34.
  • Bjarnason NH, Christiansen C. The influence of thin- ness and smoking on bone loss and response to hor- mone replacement therapy in early postmenopausal women. J Clin Endocrinol Metab 2000;85(2):590-6.
  • Rapuri PB, Allagher JC, Balhorn KE. Smoking and bone metabolism in elderly women. Bone 2000; 27(3):429-36.
  • Chapurlat RD, Ewing SK, Bauer DC, Cummings SR. Influence of smoking on the antiosteoporotic efficacy of raloxifene. J Clin Endocrinol Metab 2001;86(9):4178-82.

The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis

Year 2012, , 457 - 462, 01.12.2012
https://doi.org/10.5799/ahinjs.01.2012.04.0202

Abstract

Amaç: Bu çalışmada amacımız, postmenopozal osteoporoz tedavisinde raloksifen kullanan kadın-larda, sigara içiminin tedavinin etkinliğine olan etkisini incelemektir. Gereç ve yöntem: Bu kesitsel çalışmada, postmenopozal döneminde olan ve osteoporoz saptanan 88 (sigara içmeyen n= 54, sigara içen n= 34) olguya Raloksifen HCl (60 mg/gün) + 600 mg iyonize kalsiyum/gün + 400 IU vit D/gün tadavisi verildi. Tedavinin 1.yılı sonunda 63 olguda (Sigara içmeyen grup n= 39, Sigara içen grup n= 24) DEXA yöntemi kullanılarak L1-4 arası lomber vertebra, femur trokanter, femur boynu ve total kalça (hip) bölgelerinde kemik mineral yoğunlukları (gr/cm2) ölçüldü ve T skorları hesaplandı. İki grup arasında tedavi sonuçları karşılaştırıldı. Sonuçlar: Raloksifen tedavisine başlanmadan önce her iki grubun ortalama yaş (55,8 &plusmn;3,3\'e karşı 53,0 &plusmn;1,3 yıl), menopoz yaşları (49,3 &plusmn;2,9\'a karşı 48,1 &plusmn;2,1 yıl) menopoz süresi (5,0 &plusmn;1,3\'e karşı 7,0 &plusmn;1,4 yıl), vücut kütle indeksleri (27,2 &plusmn;3,7\'e karşı 23,4 &plusmn;0,2 kg/m2) ve estradiol düzeyleri (26,0 &plusmn;3,7\'e karşı vs 23,4 &plusmn;0,2) arasında anlamlı farklılık saptanmadı (p> 0,05). Tedavinin başlangıcında BMD değerleri tüm ölçüm bölgelerinde iki grup arasında farklı değildi (p> 0,05). Raloksifenin BMD üzerine etkisi sigara içen ve içmeyen gruplara göre karşılaştırıldığında sigara içmeyen grupta tüm ölçüm bölgelerinde BMD değerlerinde belirgin düzelme saptanırken (p< 0,05), sigara içen grupta ise tüm ölçüm bölgelerinde başlangıç değerlerine göre anlamlı bir düzelme olmadığı görüldü (p>0,05). Sonuç: Sigara içmek raloksifenin BMD üzerine olan tedavi etkinliğini olumsuz yönde etkilemektedir.

References

  • Consensus Development Statement. Who are candi- dates for prevention and treatment for osteoporosis? Osteop Int 1997;7:1-6.
  • Reginster JY. Antifracture efficacy of currently available therapies for postmenopausal osteoporosis. Drugs 2011;71(1):65-78.
  • Cosman F. Selective estrogen-receptor modulators. Clin Geriatr Med 2003;19(2):371-9.
  • Cetinkaya Demir B, Uyar Y, Ozbilgin K, Köse C. Effect of raloxifene and atorvastatin in atherosclerotic pro- cess in ovariectomized rats. J Obstet Gynaecol Res 2012 Jul 29. doi: 10.1111/j.1447-0756.2012.01969.x.
  • Riggs BL, Hartmann LC. Selective estrogen-receptor modulators - mechanisms of action and application to clinical practice. N Engl J Med 2003;348(7):618-29.
  • Ettinger B, Black DM, Mitlak BH. Reduction of vertebral fracture risk in postmanopausal women with osteopo- rosis treated with raloxifene. JAMA 1999;282(7):637- 45.
  • Helga Hansdottir. Raloxifene for older women: a review of the literature .Clin Interv Aging 2008;3(1);45-50.
  • Delmas Pierre D, Ensrud K, Adachi J. Efficacy of raloxi- fene on vertebral fracture risk reduction in postmano- pausal women with osteoporosis: four-year results from a randomized clinical tria.j Clin Endocrinol Metab 2002;87(8):3609-17.
  • Holbrook TL, Barrett-Connor E, Wingard DL. Dietary calcium and risk of hip fracture. 14-year prospective population study. Lancet 1988;2(8619):1046-9.
  • Jensen GF.Osteoporosis of the slender smoker re- visited by epidemiologic approach. Eur J Clin Invest 1986;16(3):239-42.
  • Brook JS, Balka EB, Zhang C. The smoking patterns of women in their forties: their relationship to later os- teoporosis. Psychol Rep 2012;110(2):351-62.
  • Pinheiro MM, Reis Neto ET, Machado FS, Omura F, Yang JH, Szejnfeld J, Szejnfeld VL. Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women. Rev Saude Publica 2010;44(3):479-85.
  • McKinlay SM, Bifano NL, McKinlay JB. Smoking and age at manopause in women. Ann Intern Med 1985;103(3):350-56.
  • Dytfeld J, Ignaszak-Szczepaniak M, Gowin E. Influ- ence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis. Arch Gerontol Geriatr 2011;53(2):237-42.
  • El Hage R, Jacob C, Moussa E, Baddoura R. Relative importance of lean mass and fat mass on bone min- eral density in a group of Lebanese postmenopausal women. J Clin Densitom 2011;14(3):326-31.
  • Krall EA, Dawson-Hugues B. Smoking and bone loss among postmenopausal women. J Bone Miner Res 1991;6(4):331-8.
  • Krall EA, Dawson-Hugues B. Smoking increases bone loss and decreases intestinal calcium absorp- tion. J Bone Miner Res 1999;14(2):215-20.
  • Pereira RM, Carvalho JF, Paula AP, Zerbini C. Guide- lines for the prevention and treatment of glucocor- ticoid-induced osteoporosis. Rev Bras Reumatol 2012;52(4):580-93.
  • Mizrak S, Yurekli B, Yilmaz C, Ercan G, Turan V. The effect of long-term nicotine exposure on bone mineral density and oxidative stress in female Swiss Albino rats. Arch Gynecol Obstet.2012 doi : 10.1007/s00404- 012-2535-8
  • Barbieri RL, Gochberg J, Ryan KJJ. Nicotine, coti- nine, and anabasine inhibit aromatase in human tro- phoblast in vitro. Clin Invest 1986;77(6):1727-33.
  • Silverman SL, Christiansen C, Genant HK. Efficacy of bazedoxifene in reducing new vertebral fracture risk in postmenopausal women with osteoporosis: results from a 3-year, randomized, placebo-, and active-controlled clinical trial. J Bone Miner Res 2008;23(12):1923-34.
  • Bjarnason NH, Christiansen C. The influence of thin- ness and smoking on bone loss and response to hor- mone replacement therapy in early postmenopausal women. J Clin Endocrinol Metab 2000;85(2):590-6.
  • Rapuri PB, Allagher JC, Balhorn KE. Smoking and bone metabolism in elderly women. Bone 2000; 27(3):429-36.
  • Chapurlat RD, Ewing SK, Bauer DC, Cummings SR. Influence of smoking on the antiosteoporotic efficacy of raloxifene. J Clin Endocrinol Metab 2001;86(9):4178-82.
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Savaş Erdem This is me

Ayşe Filiz Avşar This is me

Hüseyin Levent Keskin This is me

Gülin Feykan Yeğin This is me

Elçin İşlek This is me

Publication Date December 1, 2012
Published in Issue Year 2012

Cite

APA Erdem, S., Avşar, A. F., Keskin, H. L., Yeğin, G. F., et al. (2012). The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis. Journal of Clinical and Experimental Investigations, 3(4), 457-462. https://doi.org/10.5799/ahinjs.01.2012.04.0202
AMA Erdem S, Avşar AF, Keskin HL, Yeğin GF, İşlek E. The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis. J Clin Exp Invest. December 2012;3(4):457-462. doi:10.5799/ahinjs.01.2012.04.0202
Chicago Erdem, Savaş, Ayşe Filiz Avşar, Hüseyin Levent Keskin, Gülin Feykan Yeğin, and Elçin İşlek. “The Effect of Smoking on the Response to Raloxifene Treatment in Postmenopausal Osteoporosis”. Journal of Clinical and Experimental Investigations 3, no. 4 (December 2012): 457-62. https://doi.org/10.5799/ahinjs.01.2012.04.0202.
EndNote Erdem S, Avşar AF, Keskin HL, Yeğin GF, İşlek E (December 1, 2012) The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis. Journal of Clinical and Experimental Investigations 3 4 457–462.
IEEE S. Erdem, A. F. Avşar, H. L. Keskin, G. F. Yeğin, and E. İşlek, “The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis”, J Clin Exp Invest, vol. 3, no. 4, pp. 457–462, 2012, doi: 10.5799/ahinjs.01.2012.04.0202.
ISNAD Erdem, Savaş et al. “The Effect of Smoking on the Response to Raloxifene Treatment in Postmenopausal Osteoporosis”. Journal of Clinical and Experimental Investigations 3/4 (December 2012), 457-462. https://doi.org/10.5799/ahinjs.01.2012.04.0202.
JAMA Erdem S, Avşar AF, Keskin HL, Yeğin GF, İşlek E. The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis. J Clin Exp Invest. 2012;3:457–462.
MLA Erdem, Savaş et al. “The Effect of Smoking on the Response to Raloxifene Treatment in Postmenopausal Osteoporosis”. Journal of Clinical and Experimental Investigations, vol. 3, no. 4, 2012, pp. 457-62, doi:10.5799/ahinjs.01.2012.04.0202.
Vancouver Erdem S, Avşar AF, Keskin HL, Yeğin GF, İşlek E. The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis. J Clin Exp Invest. 2012;3(4):457-62.