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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2002

Open Access 01-12-2002 | Research article

Effect of vitamin D on bone mineral density of elderly patients with osteoporosis responding poorly to bisphosphonates

Authors: George A Heckman, Alexandra Papaioannou, Rolf J Sebaldt, George Ioannidis, Annie Petrie, Charlie Goldsmith, Jonathan D Adachi

Published in: BMC Musculoskeletal Disorders | Issue 1/2002

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Abstract

Background

Bisphosphonates are indicated in the prevention and treatment of osteoporosis. However, bone mineral density (BMD) continues to decline in up to 15% of bisphosphonate users. While randomized trials have evaluated the efficacy of concurrent bisphosphonates and vitamin D, the incremental benefit of vitamin D remains uncertain.

Methods

Using data from the Canadian Database of Osteoporosis and Osteopenia (CANDOO), we performed a 2-year observational cohort study. At baseline, all patients were prescribed a bisphosphonate and counseled on vitamin D supplementation. After one year, patients were divided into two groups based on their response to bisphosphonate treatment. Non-responders were prescribed vitamin D 1000 IU daily. Responders continued to receive counseling on vitamin D.

Results

Of 449 patients identified, 159 were non-responders to bisphosphonates. 94% of patients were women. The mean age of the entire cohort was 74.6 years (standard deviation = 5.6 years). In the cohort of non-responders, BMD at the lumbar spine increased 2.19% (p < 0.001) the year after vitamin D was prescribed compared to a decrease of 0.55% (p = 0.36) the year before. In the cohort of responders, lumbar spine BMD improved 1.45% (p = 0.014) the first year and 1.11% (p = 0.60) the second year. The difference between the two groups was statistically significant the first year (p < 0.001) but not the second (p = 0.60). Similar results were observed at the femoral neck but were not statistically significant.

Conclusion

In elderly patients with osteoporosis not responding to bisphosphonates, vitamin D 1000 IU daily may improve BMD at the lumbar spine.
Appendix
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Metadata
Title
Effect of vitamin D on bone mineral density of elderly patients with osteoporosis responding poorly to bisphosphonates
Authors
George A Heckman
Alexandra Papaioannou
Rolf J Sebaldt
George Ioannidis
Annie Petrie
Charlie Goldsmith
Jonathan D Adachi
Publication date
01-12-2002
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2002
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-3-6

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