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

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

Keywords

• Raloxifene, postmenopausal osteoporosis, smoking

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

Öz

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.

Anahtar Kelimeler

• Raloksifen, postmenopozal osteoporoz, sigara

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