Best New Thing: Help for Bones and Hot Flashes in One New Pill

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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The good without the bad? Duavee (bazedoxifene and conjugated estrogens) is an advancement in hormone replacement therapy you will want to know about. This new combination pill approved for the treatment of hot flashes and prevention of osteoporosis works in a different way than all other hormone replacement therapy.

The FDA has just approved Duavee 0.45mg/20mg tablets for the treatment of hot flashes associated with menopause and for the prevention of osteoporosis.

What’s cool and different about Duavee?

It’s the first and only pill that pairs estrogen with the selective estrogen receptor modulator (SERM), bazedoxifene.

Learn this: Duavee works selectively in different tissues to activate estrogen receptors in some while inhibiting estrogen activity in others. This means you get improvement in bones and relief from hot flashes (and possibly help with your cholesterol panel) with little effect on the uterus and breast. So you get favorable effects on the bones and hot flashes without stimulating the uterus or the breast.

Why is this important?

When postmenopausal women take estrogens alone, the lining of the uterus (the endometrium) becomes thickened and that can lead to hyperplasia and even cancer. That is why we usually pair estrogens with progesterone (Prempro or Climara Pro patch are examples). Well here you don’t need the progesterone and that may save you some side effects.

Duavee pairs estrogen with Bazedoxifene which helps protect the uterine lining and breast against hyperplasia that may result from estrogen-alone treatment.

Does it work?
Duavee significantly reduced the number of moderate-to-severe hot flashes by 74% at 12 weeks. Also huge was that Duavee significantly increased bone mineral density in the total hip and lumbar spine. Pfizer has also applied to have Duavee approved for prevention of vaginal dryness and vaginal atrophy.

Game on.

Dr O.

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