Effect of Raloxifene on Serum Triglycerides in Women With a History of Hypertriglyceridemia While on Oral Estrogen Therapy
Author:
Carr Molly C.1, Knopp Robert H.2, Brunzell John D.2, Wheeler Barbara S.2, Zhu Xiaodong2, Lakshmanan Mark3, Rosen Amy S.3, Anderson Pamela W.3
Affiliation:
1. Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University, Chicago, Illinois 2. Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, Washington 3. Lilly Research Laboratories, Indianapolis, Indiana
Abstract
OBJECTIVE—Raloxifene hydrochloride is a selective estrogen receptor modulator that to date has not been shown to cause hypertriglyceridemia in normal, diabetic, or hypertriglyceridemic women. This study was designed to assess the effect of raloxifene on serum triglycerides in postmenopausal women who have a history of increased hypertriglyceridemia with oral estrogen therapy.
RESEARCH DESIGN AND METHODS—This was a single-center, uncontrolled, open-label study investigating the effects of 8 weeks of raloxifene (60 mg/day) therapy on plasma lipids. The study subjects were 12 postmenopausal women, ages 49–73 years, with a documented history of oral estrogen–induced hypertriglyceridemia (serum triglycerides ≥3.39 mmol/l [≥300 mg/dl]).
RESULTS—At week 2 of the study, three (25%) of the subjects withdrew from the trial because they developed marked hypertriglyceridemia (≥11.3 mmol/l [≥1,000 mg/dl]) during raloxifene therapy. These three women had higher baseline triglyceride and glucose levels, were not being treated with lipid-lowering agents, and were more likely to have diabetes than the other study subjects. The remaining nine patients (75%) completed the 8-week trial and experienced a nonsignificant increase in mean triglyceride levels from baseline to end point. Raloxifene treatment also resulted in a significant 16% decrease in hepatic lipase activity and a 26% increase in HDL2 levels (P = 0.013 and 0.03, respectively).
CONCLUSIONS—Patients with a previous history of hypertriglyceridemia on oral estrogen therapy should have serum triglyceride levels monitored closely after beginning raloxifene therapy and may even require fibrate therapy before beginning raloxifene.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference45 articles.
1. Delmas PD, Bjarnason NH, Mitlak BH, Ravoux AC, Shah AS, Huster WJ, Draper M, Christiansen C: Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women. N Engl J Med 337: 1641–1647, 1997 2. Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Gluer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR, Multiple Outcomes of Raloxifene Evaluation Investigators: Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA 282: 637–645, 1999 3. Walsh BW, Kuller LH, Wild RA, Paul S, Farmer M, Lawrence JB, Shah AS, Anderson PW: Effects of raloxifene on serum lipids and coagulation factors in healthy postmenopausal women. JAMA 279: 1445–1451, 1998 4. Davies GC, Huster WJ, Shen W, Mitlak B, Plouffe L Jr, Shah A, Cohen FJ: Endometrial response to raloxifene compared with placebo, cyclical hormone replacement therapy, and unopposed estrogen in postmenopausal women. Menopause 6: 188–195, 1999 5. Cohen FJ, Watts S, Shah A, Akers R, Plouffe L Jr: Uterine effects of 3-year raloxifene therapy in postmenopausal women younger than age 60. Obstet Gynecol 95: 104–110, 2000
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