As a selective estrogen receptor modulator, the therapeutic effect of raloxifene is mainly reflected in the improvement of osteoporosis and the reduction of breast cancer risk. The following is a classification explanation of specific treatment effects and clinical data support.

1. Treatment effect of osteoporosis

(1) Bone density enhancement: Clinical studies have shown that treating with a daily dose of 60mg for 12 months can increase lumbar spine bone density by 2-3%, with an increase of 4-6% at 24 months.

(2) Risk reduction of fractures: Continuous treatment for 3 years can reduce the risk of vertebral fractures by about 50%, but the preventive effect on non vertebral fractures is not yet clear.

2. Prevention effect of breast cancer

(1) Overall risk reduction: among postmenopausal women with high risk factors for breast cancer, 5-year treatment can reduce the risk of invasive breast cancer by about 44%.

(2) Specific protection: the prevention effect of estrogen receptor positive breast cancer is more significant, and the risk can be reduced by 76%, but it has no significant effect on receptor negative types.

3 Treatment effect time curve

(1) Time of onset: The improvement of bone density can be detected as early as 6 months after the drug is used, and the reduction of breast cancer risk needs to be continued for more than 2 years.

(2) Sustained effect: The bone density gain can be maintained for 12-18 months after drug withdrawal, but the prevention effect of breast cancer rapidly weakens after drug withdrawal.

4 Factors affecting therapeutic efficacy

(1) Age factor: The bone density of patients under 70 years old increased more significantly, but the prevention effect of breast cancer was not significantly related to age.

(2) Basic condition: Patients with baseline bone density T value ≤ -2.5 have a greater reduction in fracture risk, reaching 60-70%.

5 Requirements for efficacy monitoring

(1) Bone density testing: It is recommended to perform DXA scans every 12-24 months before and after treatment to evaluate changes in lumbar and hip bone density.

(2) Breast screening: breast clinical examination and mammography should be carried out every year to monitor the preventive effect and potential abnormalities of breast cancer.