Are bisphosphonates effective and safe in patients with low serum vitamin D levels?
Antoniucci DM et al. – Study concludes that physicians should continue to prescribe adequate supplies of vitamin D within the target of therapy; for example, above 50 nmol/l during therapy with bisphosphonates, since adequate vitamin D levels counteract elevated parathyroid hormone levels, reduce bone resorption and have a positive effect on neuromuscular performance and on the risk of falling and bone strength.Methods- Aim was to investigate if vitamin D deficiency may blunt the increase in bone mineral density during treatment with bisphosphonates (etidronate)
- Data was analyzed from 1000 randomly selected pts from alendronate Phase III Trials, FIT 1 and FIT 2
- All pts were treated with alendronate
- Pts who had a daily calcium intake of <1000 mg were supplied with 500 mg calcium and 250 IU cholecalciferol
Results- No difference in the change in BMD of the lumbar spine and hips pts with vit D deficiency, vit D insufficiency and sufficient vit D levels at baseline
- At first sight, it seems reassuring that baseline vit D levels do not interfere with the treatment effect
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