Therapy
Raloxifene lowers Lp(a), with the effect fading over longer treatment duration, a meta-analysis of 7 trials in postmenopausal women (Cardiovasc Drugs Ther 2017)
Original title: Raloxifene Lowers Plasma Lipoprotein(a) Concentrations: a Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials
This systematic review and meta-analysis of randomised placebo-controlled trials examined raloxifene effect on plasma Lp(a) in postmenopausal women, searching literature through May 2015. Pooling 7 eligible trials with 10 treatment arms, raloxifene significantly reduced Lp(a) (standardised mean difference -0.42, 95% CI -0.65 to -0.19, P<0.001), a medium effect size present at both doses of 60 mg/day or less (SMD -0.43, 95% CI -0.73 to -0.13, P=0.004) and above 60 mg/day (SMD -0.36, 95% CI -0.68 to -0.05, P=0.025). No significant relationship was found between dose or baseline Lp(a) and the effect size, but a significant inverse association was seen between treatment duration and raloxifene Lp(a)-lowering effect (P=0.001). The findings show oral raloxifene significantly reduces plasma Lp(a) in postmenopausal women, with the effect diminishing over longer treatment duration.
Original abstract
Background And Aims: Lipoprotein(a) (Lp(a)) is a proatherogenic plasma lipoprotein and an independent risk factor for atherosclerotic cardiovascular disease. We investigated the effects of raloxifene, selective estrogen receptor modulator, on circulating Lp(a) levels in postmenopausal women using a systematic review and meta-analysis of randomized controlled trials (RCTs).
Methods: To identify relevant studies, electronic databases (PUBMED, Scopus, Web of Science, and Google Scholar) were searched by up to May 2015 to find controlled trials exploring the effects of oral raloxifene treatment on plasma Lp(a) levels in postmenopausal women. A random-effects model and generic inverse variance method were used for quantitative data synthesis.
Results: Overall, seven eligible RCTs with ten treatment arms were included in this meta-analysis. Meta-analysis suggested a significant reduction of Lp(a) levels after treatment with raloxifene (standardized mean difference (SMD) -0.42; 95% CI -0.65, -0.19; p < 0.001), which may be considered as a medium effect size. When the studies were categorized according to the administered dose, there was a significant effect in both subsets of studies with administered doses ≤60 mg/day (SMD -0.43; 95% CI -0.73, -0.13; p = 0.004) and >60 mg/day (SMD -0.36; 95% CI -0.68, -0.05; p = 0.025). No significant association between the changes in plasma concentrations of Lp(a) with dose and baseline Lp(a) levels was found in the random-effects meta-regression analysis. However, a significant inverse association was observed between the Lp(a)-lowering effect of raloxifene and duration of treatment (p = 0.001).
Conclusions: Results of the present meta-analysis showed a reduction in plasma Lp(a) concentrations of postmenopausal women with oral raloxifene treatment.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.