Can the fast bone loss in osteoporotic and osteopenic patients be stopped with active vitamin D metabolites?
The aim of this study was to evaluate whether fast trabecular bone loss in osteoporotic and osteopenic patients can effectively be treated with active vitamin D metabolites. Thirty-one osteoporotic and osteopenic patients were monitored between 4 and 22 months before and between 8 and 18 months during the treatment. Fast bone losers were designated as osteoporotic or osteopenic patients with a loss of trabecular bone density in the radius of 3% or more calculated for 1 year. For this differentiation, the high precise peripheral quantitative computed tomography system (DENSISCAN 1000) was used (reproducibility 0.3% in mixed collectives). The pretreatment loss and the "gain" under treatment with active vitamin D metabolites was calculated for 1 year. The treatment consisted of either 0.5 micro;g calcitriol daily or 1 micro;g of alfacalcidol daily. Before treatment, the trabecular bone loss in the radius/year was -6.6 +/- 0.5% (mean +/- SEM). After treatment with vitamin D metabolites, the trabecular bone gain in the radius/year was 0.01 +/- 0.6% (mean +/- SEM). The difference was highly significant (P < 0.001). In contrast to this, the loss of cortical bone density before treatment was -1.8 +/- 0.3% (mean +/- SEM) and the reduced loss after treatment -0.2 +/- 0.4% (mean +/- SEM), both values calculated for 1 year. This difference was less significant (P < 0. 05). This study shows that the treatment with active vitamin D metabolites is very effective in slowing fast trabecular bone loss in osteoporotic and osteopenic patients.
Dambacher
M A
MA
University Clinic Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland.
Kranich
M
M
Schacht
E
E
Neff
M
M
D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000188:drug therapy* / Q000473:pathology; D001842:Bone and Bones / Q000187:drug effects / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000473:pathology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000627:therapeutic use*
D014807:Vitamin D