Pre-surgical promestriene therapy in postmenopausal women with stress urinary incontinence
Tinelli et al, 2007, Gynecol Endocrinol, 23(8): 445-50

Objective. This study was aimed at evaluating the efficacy of therapy with promestriene, a synthetic diethyl-ether of estradiol with no distal hormonal effects, in patients undergoing surgical correction for stress incontinence (SUI).
 
Materials & Methods. 98 healthy PMW, non-users of HRT with a diagnosis of SUI and vulvo-vaginal dystrophy, were recruited and openly randomized into 2 main groups.
Group 1- 48 pts, received promestriene 10mg daily by vaginal capsule for 21 days before the operation.
Group 2 – 50 pts, underwent the surgical operation with TVT (tension-free vaginal tape) directly without pharmacological preparation.
 
Results. The 2 groups were homogeneous in terms of age, parity & body mass index. There were no significant differences between the 2 groups with respect to the time required to accomplish the TVT, blood loss, length of hospital stay, blood component measurements and postoperative subjective symptoms. There were slight differences postoperatively in problems during intercourse and the appearance of new genital symptoms.
 
Conclusions. The results confirm the efficacy of TVT for SUI. Preoperative administration of promestriene seems to favour trophism & vascularisation of the whole muscular and fascial support of the pelvic floor and facilitates performance of the operation.
 

Role of raloxifene as a potent inhibitor of experimental postmenopausal polyarthritis and osteoporosis
Jochems et al, 2007, Arthritis & Rheumatism, 56(10): 3261-3270

Objective. In postmenopausal rheumatoid arthritis (RA), both estrogen deficiency and the inflammatory disease contribute to the development of generalized osteoporosis. HRT with estradiol preserves BMD and ameliorates arthritis, but long-term therapy is no longer an option due to significant side effects. Here, a mouse model of human RA is used to test the hypothesis that a SERM, the raloxifene analog LY117018, could be beneficial in the treatment of both arthritis and osteoporosis.
 
Results of this study show that treatment with raloxifene dramatically decreased the frequency and severity of arthritis. Effective preservation of bone and cartilage was seen in raloxifene-exposed mice, as demonstrated by increased BMD, and decreased serum levels of cartilage oligometric matrix protein in the raloxifene treated mice compared with controls. Decreased levels of mRNA for both tumour necrosis factor α and RANKL in spleen cells from raloxifene-treated arthritic mice indicated an immunosuppressive action of this SERM.

Conclusion. In a well-established model of postmenopausal RA, the raloxifene analog LY117018 potently inhibits the progression of arthritis and the association development of osteoporosis, both in a prophylactic and in a therapeutic regimen. Since long-term HRT has been associated with significant side effects, raloxifene may be a useful adjuvant treatment for postmenopausal RA.