Endocrinol Metab.  2010 Dec;25(4):305-309. 10.3803/EnM.2010.25.4.305.

The Effects of Combined Treatment of Alendronate Plus Active or Plain Vitamin D on the Vitamin D Metabolism and Bone Turnover Markers in Patients with Osteoporosis

• Koo JH
• Kim HK
• Kim IS
• Kim EK
• Chung YS

• KMID: 1497755
• DOI: http://doi.org/10.3803/EnM.2010.25.4.305

Abstract

BACKGROUND
The purpose of this study was to evaluate the effects of combined treatment with alendronate plus active or plain vitamin D on the vitamin D metabolism and bone turnover markers in patients with osteoporosis.
METHODS
We investigated 297 osteoporosis outpatients who were treated with Maxmarvil(R) (alendronate 5 mg plus calcitriol 0.5 microg) daily or Fosamax Plus(R) (alendronate 70 mg plus cholecalciferol 2,800 IU) weekly for 1 year. The serum levels of 25(OH)D, parathyroid hormone (PTH), calcium, phosphorus, osteocalcin and N-telopeptide were measured at baseline and after 3, 6, and 12 months of treatment.
RESULTS
The data of 72 of the 297 patients were analyzed. In the Maxmarvil(R) group (n = 45), the serum PTH significantly decreased by 17% from baseline at 6 months (microd = -6.10; +/- 0.85 SE; P < 0.05) and it remained suppressed to 12 months. The serum 25(OH)D tended to increase, but without significance. In the Fosamax Plus(R) group (n = 27), the serum 25(OH)D significantly increased by 77% from baseline at 3 months (microd = 9.87; +/- 2.32 SE; P < 0.05) and it remained significantly higher than baseline at 6 months (microd = 3.49; +/- 0.86 SE; P < 0.05) and 12 months (microd = 10.47; +/- 0.71 SE; P < 0.001). However, the serum PTH showed no significant decrease. In the Maxmarvil(R) group, the serum osteocalcin significantly decreased by 26% from baseline at 12 months (microd = -5.15; +/- 0.35 SE; P < 0.05), and in the Fosamax Plus(R) group, the serum osteocalcin significantly decreased by 19% from baseline at 6months (microd = -2.64; +/- 0.73 SE; P < 0.05) and it remained suppressed to 12 months (microd = -2.99; +/- 0.37 SE; P = 0.32) without significance.
CONCLUSION
Maxmarvil(R) and Fosamax Plus(R) both improved the bone metabolism in Korean osteoporosis patients. Maxmarvil(R) significantly lowered the serum PTH levels, whereas Fosamax Plus(R) significantly elevated the serum 25(OH)D levels.

Keyword

Calcitriol; Cholecalciferol; Bisphosphonates; Bone metabolism

MeSH Terms

Alendronate
Calcitriol
Calcium
Cholecalciferol
Collagen Type I
Diphosphonates
Humans
Osteocalcin
Osteoporosis
Outpatients
Parathyroid Hormone
Peptides
Phosphorus
Vitamin D
Vitamins
Alendronate
Calcitriol
Calcium
Cholecalciferol
Collagen Type I
Diphosphonates
Osteocalcin
Parathyroid Hormone
Peptides
Phosphorus
Vitamin D
Vitamins

Figure

• 

  Fig. 1. The effect of combined treatment of alendronate and active or plain vitamin D on serum 25(OH)D. In the Maxmarvil® group, serum 25(OH)D showed no significant change. However, in the Fosamax Plus® group, serum 25(OH)D increased by 77% from baseline at 3 months (μ d = 9.87; ± 2.32 SE; P < 0.05) and remained significantly higher than baseline at 6 months (μ d = 3.49; ± 0.86 SE; P < 0.05) and 12 months (μ d = 10.47; ± 0.71 SE; P < 0.001).* P < 0.05 vs. baseline value; † P < 0.05 vs. Fosamax Plus® group.

• 

  Fig. 2. The effects of combined treatment of alendronate and active or plain vitamin D on serum PTH. In the Maxmarvil® group, serum PTH decreased by 17% from baseline at 6 months (μ d = −6.10; ± 0.85 SE; P < 0.05) and remained suppressed at 12 months (μ d = −3.34; ± 0.95 SE; P = 0.54) without significance. In the Fosamax Plus® group, serum PTH showed no significant change.* P < 0.05 vs. baseline value; † P < 0.05 vs. Fosamax Plus® group.

• 

  Fig. 3. The effects of combined treatment of alendronate and active or plain vitamin D on serum bone turnover markers. In the Maxmarvil® group, serum osteocalcin decreased by 26% from baseline at 12 months (μ d = −5.15; ± 0.35 SE; P < 0.05). In the Fosamax Plus® group, serum osteocalcin decreased by 19% from baseline at 6 months (μ d = −2.64; ± 0.73 SE; P < 0.05) and remained suppressed at 12 months (μ d = −2.99; ± 0.37 SE; P = 0.32) without significance. In both group, N-telopeptide showed no significant change.* P < 0.05 vs. baseline value.

Reference

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