Figure 1.
PRISMA flowchart representing the study selection process.
Figure 2.
Quality assessment of the entered studies in the review.
Table 1.
Characteristics of evaluated studies.
| Author (years) Reference | Country | Type of study | Sample size | Age (years) | RA1severity | Diseases | Dosage | Lumbar spine | Hip BMD10 | Treatment duration | Glucocorticoids therapy duration | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lee et al. (2014) [17] | South Korea | Clinical trial case-control study | 130 RLX2:86 C3:44 | RLX:60.1 C:59.3 | Low to severe RA | RA: 86 SLE8: 7 Sjogren's syndrome: 15 Scleroderma: 11 Behcet's disease: 11 Other rheumatic diseases: 5 | RLX (60 mg/day) plus elemental calcium (1,200 mg/day) | +0.9±0.7%; P=0.04 vs. +0.4±0.1%; P=0.05 | +1.1±0.5%; P=0.03 vs. 1.5±0.7%; P=0.04 | 12months | Long-term corticosteroid therapy | Total hip and lumbar spinal BMD scores increased due to using RLX. |
| Mok et al. (2010) [18] | China | Parallel-group randomised double-blinded placebo-controlled trial | 114 RLX:57 C:57 | 55.3 | Low to severe RA | SLE: 62 RA: 31 IM9:9 Others: 28 | 60 mg/day | +1.3±0.4%; P=0.004 | +1.0±0.4%; P=0.01 | 12months | Prednisolone received for 62.2months (6.7mg/day) | RLX leads to increasing the spinal and hip BMD after 12 months of treatment. |
| Mokuda et al. (2012) [19] | Japan | Cross-sectional study | RLX:30 ALN4:50 C:20 | RLX:72 ALN:74 C:76 | Low RA disease activity (DAS287 ≤3.2) | RA | 60 mg/day | -- | -- | -- | -- | A significant difference in serum undercarboxylated osteocalcin levels was reported between RLX and control groups. |
| Solomon et al. (2002) [20] | USA | Retrospective chart review | 236 MHT5:51 RLX:7 A: 45 E6: 5 Calcitonin: 23 | 60.3 | RA | -- | -- | -- | -- | 15.4 months | RA patients taking oral glucocorticoids did not undergo bone densitometry and/or receive prescription medications for osteoporosis. | |
| Stoica et al. (2013) [21] | Romania | Clinical trial case-control study | 30 | Range: 55–64 | RA | 60 mg/day | -- | -- | -- | Long-term corticosteroid therapy | Raloxifene significantly increased spinal and hip BMD after 12 months of treatment in RA postmenopausal women. | |
| Guiducci et al. (2005) [22] | Italy | In vitro case-control study | RA:4 C:4 | Matched between two groups | -- | RA | -- | -- | -- | -- | -- | Higher levels of plasminogen activator inhibitor-1, lower levels of urokinase plasminogen activator, and lower levels of urokinase plasminogen activator receptor were reported in RA patients treated with RLX in comparison to those reported in the control group. |
[i] 1- Rheumatoid Arthritis; 2-Raloxifene;3- Control;4-Alendronate;5- Menopause hormone therapy ;6- Etidronate;7- Disease Activity Score;8- Systemic Lupus Erythematosus;9- Inflammatory Myopathy; 10- Bone mineral density