Selectieve oestrogeenreceptormodulatoren (SERM's) bij postmenopauzale vrouwen

W. Hart en J.C. Netelenbos

Selective oestrogen receptor modulators (SERMs) in postmenopausal women

- Selective oestrogen receptor modulators (SERMs) constitute a group of new drugs which mimic oestrogen in some organs and tissues but have an oestrogen antagonistic mode of action in other tissues.

- In postmenopausal women these compounds have a favourable effect on lipoprotein cholesterol levels in the blood and bone mineral density, thereby reducing fracture risk, especially in the vertebral column.

- In contrast to oestrogen therapy SERMs reduce the risk of mammary carcinoma.

- Currently tamoxifen and raloxifene are the best known SERMs.

- Tamoxifen increases endometrial hyperplasia and the risk of endometrial carcinoma.

- Raloxifene inhibits uterine tissue proliferation and does not appear to influence the endometrium directly. Raloxifene appears to be finding a place for itself in the treatment and prevention of osteoporosis in postmenopausal women.

- At this moment it is not yet possible to foresee what the impact of SERMs will be in the treatment and prevention of cardiovascular diseases and breast cancer.