title: Vitamin D and calcium in the prevention of corticosteroid induced osteoporosis: a 3 year followup.
abstract: OBJECTIVE
  To determine the efficacy and safety of vitamin D 50,000 units/week and calcium 1,000 mg/day in the prevention of corticosteroid induced osteoporosis.
  
  
  METHODS
  A minimized double blind, placebo controlled trial in corticosteroid treated subjects in a tertiary care university affiliated hospital. The sample was 62 subjects with polymyalgia rheumatica, temporal arteritis, asthma, vasculitis, or systemic lupus erythematosus. The primary outcome measure was the percentage change in bone mineral density (BMD) of the lumbar spine in the 2 treatment groups from baseline to 36 mo followup.
  
  
  RESULTS
  BMD of the lumbar spine in the vitamin D and calcium treated group decreased by a mean (SD) of 2.6% (4.1%) at 12 mo, 3.7% (4.5%) at 24 mo, and 2.2% (5.8%) at 36 mo. In the placebo group there was a decrease of 4.1% (4.1%) at 12 mo, 3.8% (5.6%) at 24 mo, and 1.5% (8.8%) at 36 mo. The observed differences between groups were not statistically significant. The difference at 36 mo was-0.693% (95% CI -5.34, 3.95).
  
  
  CONCLUSIONS
  Vitamin D and calcium may help prevent the early loss of bone seen in the lumbar spine as measured by densitometry of the lumbar spine. Longterm vitamin D and calcium in those undergoing extended therapy with corticosteroids does not appear to be beneficial.
authors.affiliation: Rheumatic Disease Unit, St. Joseph's Hospital, McMaster University, Hamilton, Canada.
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
authors.forename: W G
authors.initials: WG
authors.lastname: Bensen
authors.forename: F
authors.initials: F
authors.lastname: Bianchi
authors.forename: A
authors.initials: A
authors.lastname: Cividino
authors.forename: S
authors.initials: S
authors.lastname: Pillersdorf
authors.forename: R J
authors.initials: RJ
authors.lastname: Sebaldt
authors.forename: P
authors.initials: P
authors.lastname: Tugwell
authors.forename: M
authors.initials: M
authors.lastname: Gordon
authors.forename: M
authors.initials: M
authors.lastname: Steele
authors.forename: C
authors.initials: C
authors.lastname: Webber
authors.forename: C H
authors.initials: CH
authors.lastname: Goldsmith
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000368:Aged; D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000627:therapeutic use* / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control*; D010919:Placebos; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D010919:Placebos; D014807:Vitamin D; D002118:Calcium