The Benefits of Raloxifene Use in Postmenopausal Women with Alzheimer’s Disease

Abstract

This qualitative systematic review aims to compile evidence to assess potential cognitive benefit with raloxifene use in postmenopausal women with Alzheimers disease. PubMed, EMBASE, and Cochrane Library databases were searched using the terms raloxifene, Evista, postmenopausal, Alzheimers, demen- tia, cognitive, and cognition. Reviewed studies were limited to human subjects written in the English language between 2002 and January 2017. Of 36 studies, only four articles were included in the as- sessment. The most reliable results come from the MORE trial which describes a dose-dependent (120 mg/day) reduction in cognitive impairment and lower risk of developing Alzheimers disease after three years of raloxifene use in postmenopausal women who were considered cognitively normal at baseline. The other three articles reviewed in this study showed no significant cognitive benefit associated with raloxifene treatment. However, all three of these studies showed high potential for bias based on this review of the cognitive assessment method, intervention, study duration, and population. Two of these three studies utilized a dose that was too low (60 mg/day) in cognitively normal women. The third study showing bias had the smallest total population (n=42) but it used an appropriate dose of 120 mg/day and it was the only study to include participants with an established diagnosis of Alzheimers disease. Based on the results of this database search and analysis, there appears to be insufficient available liter- ature that includes an appropriate raloxifene dose, study duration, assessment method, and population. This suggests justification for future clinical trials to properly evaluate the potential cognitive benefit of raloxifene in postmenopausal women with Alzheimers disease.