A nice-blended scotch of a pill?*

At least that is the market strategy of Wyeth Pharmaceuticals who will release Aprela within the next two years. This two-fer pill is Premarin wrapped up with Wyeth's new selective estrogen receptor modulator (SERM) drug called bazedoxifene or more lyrically by its brand name Viviant.

SERMs are molecules that are sort of estrogen-shaped and act more or less like estrogen at cellular receptors, turning their estrogen-based actions on or off. Currently available SERMs all have their good and their not-so-good qualities: Clomiphene hyperstimulates the ovaries to produce eggs for the infertile who take them. Tamoxifen blocks estrogen at the breast to prevent breast cancer recurrence but acts like estrogen on the uterus and can be associated with the development of endometrial cancer. Evista acts like estrogen on bone receptors thus slowing postmenopausal bone loss, blocks estrogen at the breast like tamoxifen, but screws around with brain estrogen receptors and can make hot flashes worse.

So the race is on to build a better SERM, and Wyeth is winning to be #2 on the market with Viviant having just been issued an 'approvable' letter from the FDA. So no big deal yet, just another SERM against osteoporosis competing with Evista. So here's Wyeth's ace-in-the-hole: one acronym...TSEC.

Tissue selective estrogen complex or the TSEC class of compounds was developed to offer a new menopausal treatent option "that, for the first time, partners a selective estrogen receptor modulator (SERM) with estrogens." The SERM protects the bones and uterus, the estrogen quiets the fire of the flashes. No information is available as to how the breasts fare in this mad dash for the estrogen receptors.
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*See April 28th post