Internal Med Medical News about bisphosphonates;low serum vitamin D levels

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Are bisphosphonates effective and safe in patients with low serum vitamin D levels?
International Journal of Clinical Rheumatology, 05/07/09

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

Exclusive Author Commentary
lems, 06/03/09

I am happy with the paper, since it is dealing with a clinically relevant question: are the widely prescribed bisphosphonates effective and safe in patients with low serum vitamin D levels. I suppose it is attractive for clinicians to read about the consequences of prescribing a bisphosphonate in patients with a low vitamin D level.

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