Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

Calcifediol (25-hydroxyvitamin D) improvement and calcium-phosphate metabolism of alendronate sodium/vitamin D3 combination in Chinese women with postmenopausal osteoporosis: a post hoc efficacy analysis and safety reappraisal

Authors: Er-Yuan Liao, Zhen-Lin Zhang, Wei-Bo Xia, Hua Lin, Qun Cheng, Li Wang, Yong-Qiang Hao, De-Cai Chen, Hai Tang, Yong-De Peng, Li You, Liang He, Zhao-Heng Hu, Chun-Li Song, Fang Wei, Jue Wang, Lei Zhang

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

Login to get access

Abstract

Background

Vitamin D (VD) insufficiency or deficiency is a frequent comorbidity in Chinese women with postmenopausal osteoporosis (PMO). The present study aimed to investigate 25-hydroxyvitamin D [25(OH) D] improvement and calcium-phosphate metabolism in Chinese PMO patients treated with 70 mg of alendronate sodium and 5600 IU of vitamin D3 (ALN/D5600).

Methods

Chinese PMO women (n = 219) were treated with 12-month ALN/D5600 (n = 111) or calcitriol (n = 108). Changes in 25(OH) D at month 12 were post hoc analyzed by the baseline 25 (OH) D status using the longitudinal analysis. The main safety outcome measures included serum calcium and phosphate and 24-h urine calcium, and the repeated measures mixed model was used to assess the frequencies of the calcium-phosphate metabolic disorders.

Results

Absolute change in mean serum 25(OH) D level was the greatest in VD-deficient patients and least in VD-sufficient patients at months six and 12 (both, P < 0.01). Serum calcium level remained significantly lower in the ALN/D5600 treatment group than in the calcitriol treatment group throughout the 12 months. Mean 24-h urine calcium slightly increased in the ALN/D5600 treatment group and significantly increased in the calcitriol treatment group (+ 1.1 and + 0.9 mmol/L at months six and 12; both, P < 0.05). Calcitriol treatment was associated with more frequent hypercalciuria at month six (9.4% vs. 18.5%, P = 0.05), but not at month 12 (12.3% vs. 13.0%).

Conclusion

Baseline VD status predicted 25(OH) D improvement in PMO patients on 12-month ALN/D5600 treatment. The daily use of 0.25 μg of calcitriol was associated with more frequent hypercalciuria at month six, compared to ALN/5600 treatment, necessitating the safety re-evaluation of calcitriol at a higher dosage.
Appendix
Available only for authorised users
Literature
1.
go back to reference Nih Consensus Development Panel on Osteoporosis Prevention D, Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785–95.CrossRef Nih Consensus Development Panel on Osteoporosis Prevention D, Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785–95.CrossRef
2.
3.
go back to reference Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(Suppl 2):S3–7.CrossRefPubMed Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(Suppl 2):S3–7.CrossRefPubMed
4.
go back to reference Si L, Winzenberg TM, Chen M, Jiang Q, Palmer AJ. Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. Curr Med Res Opin. 2015;31:1149–56.CrossRefPubMed Si L, Winzenberg TM, Chen M, Jiang Q, Palmer AJ. Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. Curr Med Res Opin. 2015;31:1149–56.CrossRefPubMed
5.
go back to reference Reid IR. Short-term and long-term effects of osteoporosis therapies. Nat Rev Endocrinol. 2015;11:418–28.CrossRefPubMed Reid IR. Short-term and long-term effects of osteoporosis therapies. Nat Rev Endocrinol. 2015;11:418–28.CrossRefPubMed
6.
go back to reference Lim SK, Kung AW, Sompongse S, Soontrapa S, Tsai KS. Vitamin D inadequacy in postmenopausal women in eastern Asia. Curr Med Res Opin. 2008;24:99–106.CrossRefPubMed Lim SK, Kung AW, Sompongse S, Soontrapa S, Tsai KS. Vitamin D inadequacy in postmenopausal women in eastern Asia. Curr Med Res Opin. 2008;24:99–106.CrossRefPubMed
7.
go back to reference Hansen KE, Johnson RE, Chambers KR, Johnson MG, Lemon CC, Vo TN, et al. Treatment of vitamin D insufficiency in postmenopausal women: a randomized clinical trial. JAMA Intern Med. 2015;175:1612–21.CrossRefPubMedPubMedCentral Hansen KE, Johnson RE, Chambers KR, Johnson MG, Lemon CC, Vo TN, et al. Treatment of vitamin D insufficiency in postmenopausal women: a randomized clinical trial. JAMA Intern Med. 2015;175:1612–21.CrossRefPubMedPubMedCentral
8.
go back to reference Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus MJ, et al. The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int. 2014;25:1439–43.CrossRefPubMedPubMedCentral Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus MJ, et al. The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int. 2014;25:1439–43.CrossRefPubMedPubMedCentral
9.
go back to reference Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, et al. Alendronate sodium/vitamin D3 combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women: a 6-month, randomized, open-label, active-comparator-controlled study with a 6-month extension. Osteoporos Int. 2015;26:2365–74.CrossRefPubMedPubMedCentral Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, et al. Alendronate sodium/vitamin D3 combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women: a 6-month, randomized, open-label, active-comparator-controlled study with a 6-month extension. Osteoporos Int. 2015;26:2365–74.CrossRefPubMedPubMedCentral
10.
go back to reference Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, et al. Characteristics associated with bone mineral density increase by 1-year ALN/D5600 treatment in a randomized, controlled study on postmenopausal osteoporosis in Chinese women. The American Society for Bone and Mineral Research Annual Meeting, October 9-12. Seattle; 2015. Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, et al. Characteristics associated with bone mineral density increase by 1-year ALN/D5600 treatment in a randomized, controlled study on postmenopausal osteoporosis in Chinese women. The American Society for Bone and Mineral Research Annual Meeting, October 9-12. Seattle; 2015.
11.
go back to reference Bone HG, Hosking D, Devogelaer JP, Tucci JR, Emkey RD, Tonino RP, et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med. 2004;350:1189–99.CrossRefPubMed Bone HG, Hosking D, Devogelaer JP, Tucci JR, Emkey RD, Tonino RP, et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med. 2004;350:1189–99.CrossRefPubMed
12.
go back to reference Tilyard MW, Spears GF, Thomson J, Dovey S. Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med. 1992;326:357–62.CrossRefPubMed Tilyard MW, Spears GF, Thomson J, Dovey S. Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med. 1992;326:357–62.CrossRefPubMed
13.
go back to reference Park JH, Park KH, Cho S, Choi YS, Seo SK, Lee BS, et al. Concomitant increase in muscle strength and bone mineral density with decreasing IL-6 levels after combination therapy with alendronate and calcitriol in postmenopausal women. Menopause. 2013;20:747–53.CrossRefPubMed Park JH, Park KH, Cho S, Choi YS, Seo SK, Lee BS, et al. Concomitant increase in muscle strength and bone mineral density with decreasing IL-6 levels after combination therapy with alendronate and calcitriol in postmenopausal women. Menopause. 2013;20:747–53.CrossRefPubMed
14.
go back to reference Baeksgaard L, Andersen KP, Hyldstrup L. Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women. Osteoporos Int. 1998;8:255–60.CrossRefPubMed Baeksgaard L, Andersen KP, Hyldstrup L. Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women. Osteoporos Int. 1998;8:255–60.CrossRefPubMed
15.
go back to reference Cangussu LM, Nahas-Neto J, Orsatti CL, Bueloni-Dias FN, Nahas EA. Effect of vitamin D supplementation alone on muscle function in postmenopausal women: a randomized, double-blind, placebo-controlled clinical trial. Osteoporos Int. 2015;26:2413–21.CrossRefPubMed Cangussu LM, Nahas-Neto J, Orsatti CL, Bueloni-Dias FN, Nahas EA. Effect of vitamin D supplementation alone on muscle function in postmenopausal women: a randomized, double-blind, placebo-controlled clinical trial. Osteoporos Int. 2015;26:2413–21.CrossRefPubMed
16.
go back to reference Munoz-Aguirre P, Flores M, Macias N, Quezada AD, Denova-Gutierrez E, Salmeron J. The effect of vitamin D supplementation on serum lipids in postmenopausal women with diabetes: a randomized controlled trial. Clin Nutr. 2015;34:799–804.CrossRefPubMed Munoz-Aguirre P, Flores M, Macias N, Quezada AD, Denova-Gutierrez E, Salmeron J. The effect of vitamin D supplementation on serum lipids in postmenopausal women with diabetes: a randomized controlled trial. Clin Nutr. 2015;34:799–804.CrossRefPubMed
17.
go back to reference Perez-Lopez FR, Brincat M, Erel CT, Tremollieres F, Gambacciani M, Lambrinoudaki I, et al. EMAS position statement: vitamin D and postmenopausal health. Maturitas. 2012;71:83–8.CrossRefPubMed Perez-Lopez FR, Brincat M, Erel CT, Tremollieres F, Gambacciani M, Lambrinoudaki I, et al. EMAS position statement: vitamin D and postmenopausal health. Maturitas. 2012;71:83–8.CrossRefPubMed
18.
go back to reference Ralston SH, Binkley N, Boonen S, Kiel DP, Reginster JY, Roux C, et al. Randomized trial of alendronate plus vitamin D3 versus standard care in osteoporotic postmenopausal women with vitamin D insufficiency. Calcif Tissue Int. 2011;88:485–94.CrossRefPubMed Ralston SH, Binkley N, Boonen S, Kiel DP, Reginster JY, Roux C, et al. Randomized trial of alendronate plus vitamin D3 versus standard care in osteoporotic postmenopausal women with vitamin D insufficiency. Calcif Tissue Int. 2011;88:485–94.CrossRefPubMed
19.
go back to reference Grimnes G, Joakimsen R, Figenschau Y, Torjesen PA, Almas B, Jorde R. The effect of high-dose vitamin D on bone mineral density and bone turnover markers in postmenopausal women with low bone mass--a randomized controlled 1-year trial. Osteoporos Int. 2012;23:201–11.CrossRefPubMed Grimnes G, Joakimsen R, Figenschau Y, Torjesen PA, Almas B, Jorde R. The effect of high-dose vitamin D on bone mineral density and bone turnover markers in postmenopausal women with low bone mass--a randomized controlled 1-year trial. Osteoporos Int. 2012;23:201–11.CrossRefPubMed
20.
go back to reference Avenell A, Mak JC. O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014;14:CD000227. Avenell A, Mak JC. O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014;14:CD000227.
21.
go back to reference Czernichow S, Fan T, Nocea G, Sen SS. Calcium and vitamin D intake by postmenopausal women with osteoporosis in France. Curr Med Res Opin. 2010;26:1667–74.CrossRefPubMed Czernichow S, Fan T, Nocea G, Sen SS. Calcium and vitamin D intake by postmenopausal women with osteoporosis in France. Curr Med Res Opin. 2010;26:1667–74.CrossRefPubMed
Metadata
Title
Calcifediol (25-hydroxyvitamin D) improvement and calcium-phosphate metabolism of alendronate sodium/vitamin D3 combination in Chinese women with postmenopausal osteoporosis: a post hoc efficacy analysis and safety reappraisal
Authors
Er-Yuan Liao
Zhen-Lin Zhang
Wei-Bo Xia
Hua Lin
Qun Cheng
Li Wang
Yong-Qiang Hao
De-Cai Chen
Hai Tang
Yong-De Peng
Li You
Liang He
Zhao-Heng Hu
Chun-Li Song
Fang Wei
Jue Wang
Lei Zhang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2090-y

Other articles of this Issue 1/2018

BMC Musculoskeletal Disorders 1/2018 Go to the issue