选择性雌激素受体调节剂(selective estrogen receptormodulators,SERMs)是一种类似于雌激素的非雌激素药物,属于非甾类化合物。由于不同组织中雌激素受体的种类和数目不同,SERMs对不同组织有选择性的差异作用:在骨和脂蛋白中表现为雌激素激动样作用,可抑制破骨细胞的骨吸收、促进成骨细胞的成骨,并调节血脂和胆固醇水平,降低低密度脂蛋白胆固醇(LDL-C),增加高密度脂蛋白胆固醇(HDL-C),而不增加三酰甘油;而在乳腺和子宫内膜中则表现为雌激素拮抗样作用,可抑制乳腺和子宫内膜的增生。
第一代SERMs代表药物为他莫昔芬(tamoxifen)和托瑞米芬(toremifene),主要用于乳腺癌术后的辅助治疗。雷洛昔芬(raloxifene)是第二代SERMs,由美国礼来公司开发生产,商品名为易维特(Evista),1997年被美国食品药品管理局批准用于绝经后妇女骨质疏松症,并于1999年10月再次获批用于治疗骨质疏松症。雷洛昔芬在动物研究和临床试验中显示,在骨和心血管系统表现为雌激素激动样作用,在子宫和乳腺则表现为雌激素拮抗样作用,可用于预防和治疗绝经后妇女的骨质疏松症、改善更年期症状,并具有潜在的心血管保护作用。
药理作用 雷洛昔芬是一种选择性雌激素受体调节剂,与雌激素受体结合后激活某些雌激素通路同时阻断其他通路。它减少骨重吸收并使骨转换生化指标降至绝经前水平,降低椎体骨折发生率、保持骨量和增加骨密度。此外,雷洛昔芬还影响脂代谢,降低总胆固醇和低密度脂蛋白(LDL)水平,而不改变高密度脂蛋白(HDL)水平。
药代动力学 动物实验表明,雷洛昔芬的口服生物利用度为5%~39%,经肝脏快速代谢并全身快速清除。其代谢物葡萄糖酸苷酶聚合物与雌激素受体亲和力较小,并且抑制细胞增生的能力也较雷洛昔芬小。
注意事项
不良反应 可见血小板数量轻度减少。偶尔出现恶心、呕吐、腹痛和消化不良、皮疹、血压升高、头痛以及氨基转移酶轻度增加等副作用。
化学性质 从丙酮结晶,熔点为143-147℃。UV最大吸收(乙醇):290nm(ε=34000)。 盐酸雷洛昔芬(Raloxifene Hydrochloride),C28H27NO4S·HCl,从甲醇-水结晶,熔点为258℃。UV最大吸收(乙醇):286nm(ε=32800)。
用途 雷洛昔芬是一种选择性雌激素受体调节剂,用于绝经后骨质疏松症的治疗和预防。
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
雷洛昔芬二甲基醚 | (6-methoxy-2-(4-methoxyphenyl)benzo[b]thiophen-3-yl)(4-(2-(piperidin-1-yl)ethoxy)phenyl)methanone | 84541-38-8 | C30H31NO4S | 501.646 |
—— | 6-methanesulfonyloxy-2-(4-methanesulfonyloxyphenyl)-3-[4-(2-piperidinoethoxy)-benzoyl]benzo[b]thiophene | —— | C30H31NO8S3 | 629.776 |
[6-甲氧基-2-(4-甲氧基苯基)苯并[b]噻吩-3-基](4-羟基苯基)甲酮 | (4-hydroxyphenyl)(6-methoxy-2-(4-methoxyphenyl)benzo[b]thiophen-3-yl)methanone | 63676-19-7 | C23H18O4S | 390.46 |
6-甲氧基-2-(4-甲氧基苯基)-3-(4-氟苯甲酰基)苯并[b]噻吩 | (4-fluorophenyl)(6-methoxy-2-(4-methoxyphenyl)benzo[b]thiophen-3-yl)methanone | 206434-77-7 | C23H17FO3S | 392.451 |
—— | [2-(4-hydroxyphenyl)-6-hydroxybenzo[b]thien-3-yl] [4-fluorophenyl]methanone | 202336-25-2 | C21H13FO3S | 364.397 |
—— | 2-dimethylamino-6-methoxy-3-[4-(2-(piperidin-1-yl)ethoxy)benzoyl]benzo[b]thiophene | 165742-76-7 | C25H30N2O3S | 438.591 |
(2-(二甲氨基)-6-甲氧基苯并[b]噻吩-3-基)(4-氟苯基)甲酮 | (2-Dimethylamino-6-methoxy-benzo[b]thiophen-3-yl)-(4-fluoro-phenyl)-methanone | 243845-88-7 | C18H16FNO2S | 329.395 |
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
雷洛昔芬N-氧化物 | raloxifene N-oxide | 195454-31-0 | C28H27NO5S | 489.592 |
—— | [2-(4-acetoxyphenyl)-6-acetoxybenzo[b]thien-3-yl][4-[2-(1-piperidinyl)ethoxy]phenyl]methanone | 84541-33-3 | C32H31NO6S | 557.667 |
—— | [2-(4-Ethenylphenyl)-6-hydroxy-1-benzothiophen-3-yl]-[4-(2-piperidin-1-ylethoxy)phenyl]methanone | —— | C30H29NO3S | 483.631 |
—— | 4-[6-Hydroxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]benzonitrile | —— | C29H26N2O3S | 482.603 |
—— | [6-O-sulfiamoyl-2-(4-O-sulfiamoyl-phenyl)benzo[b]thien-3-yl][4-[2-(1-piperidinyl)ethoxy]phenyl]methanone | —— | C42H39NO4S | 653.842 |
—— | Methyl 4-[6-hydroxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]benzoate | 185416-94-8 | C30H29NO5S | 515.63 |
4’-叔-丁基二甲基硅烷基-6-羟基雷洛昔芬 | 2-[4-[[(1,1-dimethylethyl)dimethylsilyl]oxy]phenyl]-6-hydroxybenzo[b]thiophen-3-yl 4-[2-(1-piperidinyl)ethoxy]phenyl ketone | 174264-46-1 | C34H41NO4SSi | 587.855 |
6-叔-丁基二甲基硅烷基-4’-羟基雷洛昔芬 | (6-((tert-butyldimethylsilyl)oxy)-2-(4-hydroxyphenyl)benzo[b]thiophen-3-yl)(4-(2-(piperidin-1-yl)ethoxy)phenyl)methanone | 174264-47-2 | C34H41NO4SSi | 587.855 |
—— | [2-(4-hydroxyphenyl)-6-hydroxybenzo[b]thien-3-yl][4-[2-(1-piperidinyl)ethoxy]phenyl]methane | 166975-45-7 | C28H29NO3S | 459.609 |
—— | [6-[Tert-butyl(dimethyl)silyl]oxy-2-(4-ethenylphenyl)-1-benzothiophen-3-yl]-[4-(2-piperidin-1-ylethoxy)phenyl]methanone | 1025925-22-7 | C36H43NO3SSi | 597.894 |
—— | 1-[4-[6-[Tert-butyl(dimethyl)silyl]oxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]phenyl]ethanone | 1026314-83-9 | C36H43NO4SSi | 613.893 |
—— | Methyl 4-[6-[tert-butyl(dimethyl)silyl]oxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]benzoate | 185416-95-9 | C36H43NO5SSi | 629.893 |
—— | 4-[6-[tert-butyl(dimethyl)silyl]oxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]-N-methylbenzamide | 185417-15-6 | C36H44N2O4SSi | 628.908 |
—— | [4-[6-[Tert-butyl(dimethyl)silyl]oxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]phenyl] trifluoromethanesulfonate | 185416-87-9 | C35H40F3NO6S2Si | 719.918 |
—— | 4-[6-[tert-butyl(dimethyl)silyl]oxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]-N,N-dimethylbenzamide | 1025845-03-7 | C37H46N2O4SSi | 642.935 |
—— | [6-(N-(n-butyl)carbamoyl]-2-[4-(N-(n-butyl)carbamoyl)phenyl]benzo[b]thien-3-yl][4-[2-(1-piperidinyl)ethoxy]phenyl] methanone | —— | C38H45N3O4S | 639.859 |
—— | [6-[N-(4-Chlorophenyl)carbamoyl]-2-[4-[N-(4-chlorophenyl)carbamoyl]phenyl]benzo[b]thien-3-yl][4-[2-(1-piperidinyl)ethoxy]-phenyl] methanone | —— | C42H35Cl2N3O4S | 748.73 |
—— | [6-[Tert-butyl(dimethyl)silyl]oxy-2-(4-diethoxyphosphorylphenyl)-1-benzothiophen-3-yl]-[4-(2-piperidin-1-ylethoxy)phenyl]methanone | 1027485-30-8 | C38H50NO6PSSi | 707.943 |
—— | [2-(4-Hydroxyphenyl)-6-hydroxybenzo[b]thien-3-yl][4-[2-(1-piperidinyl)ethoxy]phenyl]methanol | 174731-13-6 | C28H29NO4S | 475.609 |
3,4,5-三羟基-6-[4-[6-羟基-3-[4-[2-(1-哌啶基)乙氧基]苯甲酰基]苯并噻吩-2-基]苯氧基]四氢吡喃-2-羧酸 | Raloxifene-4'-beta-glucuronide | 182507-22-8 | C34H35NO10S | 649.719 |
甲基-1-(6-叔-丁基二甲基s基基-4'-羟基雷洛昔芬)-2,3,4-三-O-乙酰基-beta-D-葡萄糖醛酸酯 | Methyl (2S,3S,4S,5R,6S)-3,4,5-triacetyloxy-6-[4-[6-[tert-butyl(dimethyl)silyl]oxy-3-[4-(2-piperidin-1-ylethoxy)benzoyl]-1-benzothiophen-2-yl]phenoxy]oxane-2-carboxylate | 174264-48-3 | C47H57NO13SSi | 904.12 |