The effects of raloxifene on endothelial function and Inflammation in Postmenopausal women: A Meta-analysis of randomized controlled trials

Background and aim: Raloxifene treatment has been reported to be associated with cardiovascular benefits if prescribed to women during the postmenopausal period. However, a final conclusion regarding this hypothesis has not yet been achieved. We conducted a systematic review and meta-analysis to evaluate the effect of raloxifene on the endothelial function and inflammation in postmenopausal women. Methods: We systematically searched the following 4 databases from inception to 23 January 2021 without any language restrictions: Web of Science, PubMed/Medline, Embase and Scopus. The eligible randomized controlled trials (RCTs) reporting the effects of raloxifene on the flow-mediated dilatation (FMD), C-reactive protein (CRP), carotid intima-media thickness (CIMT), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and E-selectin levels, were included in the final meta-analysis. Results: A total of 16 RCTs were included in the final analysis. Raloxifene administration had no significant effect on ICAM-1 and E-selectin levels. However, we observed a decrease of the CIMT (WMD: 0.071 mm, 95% CI: -0.09 to -0.04, P = 0.000), CRP (WMD: 0.342 mg/L, 95% CI: 0.591, 0.094, p = 0.007), and VCAM-1 (WMD: 197.90 mg/L, 95% CI: 269.58 to 126.23, P = 0.000) levels in the intervention versus control groups following the prescription of this pharmacological agent. Moreover, raloxifene treatment resulted in a significant elevation of the FMD (WMD: 1.64%, 95% CI: 0.46 to 2.81, P = 0.006), particularly if the intervention was equal to or exceeded 12 weeks. Conclusion: Raloxifene might emerge as a potential therapeutic option in the management of endothelial dysfunction and inflammation in postmenopausal women.

Automated summary

A systematic review and meta-analysis evaluated the effect of Raloxifene on endothelial function and inflammation in postmenopausal women. The results showed that Raloxifene treatment had positive effects on vascular function and inflammation, including a decrease in carotid intima-media thickness, C-reactive protein, and vascular cell adhesion molecule 1 levels, as well as an increase in flow-mediated dilatation.