We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Encouraging News From the SERM Frontier

Adele L. Franks, MD; Karen K. Steinberg, PhD
JAMA. 1999;281(23):2243-2244. doi:10.1001/jama.281.23.2243.
Text Size: A A A
Published online


The discovery that pharmacologic agents can be estrogenic in some tissues while antiestrogenic in others has led to intense interest in better understanding the mechanism by which molecular structure interacts with cellular receptors to selectively affect DNA transcription in different organs. Appreciation for these selective estrogen receptor modulators (SERMs) has inevitably given way to the hope of developing one that could confer all of the benefits of estrogen without any of its risks. The first widely used SERM, tamoxifen citrate, has been found to have the antiestrogenic effect of reducing risk for breast cancer as well as beneficial estrogenic effects on serum lipids and bone density in women.1 However, tamoxifen also has the undesirable antiestrogenic effect of causing hot flashes and the undesirable estrogenic effects of increasing risk for endometrial cancer and venous thromboembolism in women.1 Because raloxifene hydrochloride, a second-generation SERM, has been shown to increase women's bone density without increasing risk for endometrial cancer,2,3 results of clinical trials designed to study its protective effects against breast cancer have been eagerly awaited.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

12 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles