Pharmacokinetic evaluation of bazedoxifene for the treatment of osteoporosis

Introduction: Bazedoxifene is a third-generation Selective Estrogen Receptor Modulator, developed on raloxifene's model, and investigated as treatment for postmenopausal osteoporosis and menopause management. Clinical trial have shown that bazedoxifene is effective as raloxifene in preventing bone loss in women at risk of osteoporosis and that in patients with osteoporosis it is effective in reducing the incidence of new vertebral fracture with a protection maintained for up 7 years. Areas covered: This drug evaluation presents the antifracture efficacy of bazedoxifine and evidence that it, unlike raloxifene, can reduce the rate of non-vertebral fractures in high-risk patients. The authors also review the effects of bazedoxifine has on reproduction tissues as well as the on lipid pattern. Additionally, the authors present the safety profile of bazedoxifine and discuss its prospects, specifically in relation to conjugated estrogen. Expert opinion: Despite its peculiar profile, bazedoxifene could be considered as a second-line therapy for women <65 - 70 years of age, where bisphopshonates are contraindicated or not well tolerated. Furthermore, the authors believe that bazedoxifene could also have its place as a first-line therapy for younger postmenopausal patients in the management of menopause and prevention of osteoporosis; this could be prescribed either by itself or in combination with conjugated estrogen. The authors also highlight the fact that the association of bazedoxifene and conjugated estrogen could also be beneficial in the treatment of climacteric syndrome in patients with menopausal symptoms.