SERM MOA

EVISTA Works Differently in the Breast and Bones
EVISTA is an estrogen agonist/antagonist, commonly known as a Selective Estrogen Receptor Modulator (SERM). EVISTA is not a hormone.

• In the bones, EVISTA appears to act as an estrogen agonist
• In the breasts, EVISTA appears to act as an estrogen antagonist

Different SERMs have different indications.¹ Only EVISTA is indicated for both the prevention and treatment of osteoporosis in postmenopausal women and for invasive breast cancer risk reduction in postmenopausal women with osteoporosis, and for the reduction in risk of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer.

EVISTA has a multiple-dose mean plasma elimination half-life of 32.5 hours, and it does not accumulate into the bone matrix.²

How a SERM Appears to Work
View the video presentation below to learn how a SERM appears to work.

EVISTA Restores Bone Remodeling Balance
EVISTA decreases resorption of bone and reduces biochemical markers of bone turnover to the premenopausal range. Balancing bone remodeling is vital in maintaining bone strength for the long term.³

• Suppression of biochemical markers of bone turnover was evident as early as 3 months and was sustained for duration of studies (24 to 36 months)
• EVISTA maintains normal bone quality

1. Manufacturers' prescribing information.
2. Data on file, Lilly Research Laboratories (EVI20061113B).
3. Clin Ther. 2005;27:1-11.
4. Disorders of Bone and Mineral Metabolism. New York, NY: Raven Press, Ltd; 1992:841-844.
5. Osteoporosis. 2nd ed. San Diego, CA: Academic Press; 2001;2:459-468.
6. N Engl J Med. 1986;314:1676-1686.

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EVISTA is a registered trademark of Eli Lilly and Company.
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Important Safety Information for EVISTA

Contraindications
EVISTA is contraindicated in nursing women and in women who are or may become pregnant, as it may cause fetal harm. EVISTA is also contraindicated in women with active or past venous thromboembolic events (VTEs), including deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis.

Warnings and Precautions
In a study of postmenopausal women at high risk for cardiovascular disease taking EVISTA, there was no increase in the incidence of stroke; however, there was an increase in death due to stroke. EVISTA also did not increase or decrease the incidence of overall mortality, cardiovascular mortality, or heart attack. The risk-benefit balance should be considered in women at risk for stroke, such as those with prior stroke or transient ischemic attack (TIA), atrial fibrillation, hypertension, or cigarette smoking. EVISTA should be used with caution in patients with hepatic impairment or moderate/severe renal impairment since safety and efficacy have not been established in these patients. The safety of concomitant use of EVISTA with systemic estrogens has not been established and its use is not recommended.

Adverse Reactions
The common adverse reactions considered to be drug related:

Adverse reactions occurring in the clinical trials at a frequency ≥2.0% in either group and in more EVISTA-treated women than in placebo-treated women include:

The majority of adverse reactions occurring during the osteoporosis prevention and treatment studies were mild and generally did not require discontinuation of therapy.

Please see Contraindications, Warnings and Precautions, and Adverse Reactions sections of full Prescribing Information for other Important Safety Information.