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CALCITRIOL FOR POSTMENOPAUSAL OSTEOPOROSIS.

Several studies have examined the effect of calcitriol (1,25-dihydroxyvitamin D3) on bone density in women with postmenopausal osteoporosis, but these studies yielded conflicting results and were too small to determine whether calcitriol reduces the incidence of fractures.

This trial enrolled 622 postmenopausal women (age 50-79) with one or more vertebral compression fractures. Patients were randomized to receive either calcitriol (0.25 micrograms twice a day) or calcium supplementation (1 gram a day). The baseline daily diet in both groups included about 900 mg of calcium. After 3 years of follow-up, patients treated with calcitriol had significantly fewer new vertebral fractures than patients taking calcium (9.9 vs. 31.5 fractures per 100 patient-years). The incidence of peripheral fractures was also reduced in the calcitriol group. Side effects were similar in the two groups. Only two calcitriol-treated women had to withdraw because of persistently elevated serum calcium levels, and no subjects had clinically evident nephrolithiasis.

These authors conclude that calcitriol is "an important therapeutic option" in postmenopausal osteoporosis. An editorialist, however, still regards this use of calcitriol as "experimental."

— ASB

Published in Journal Watch General Medicine February 14, 1992

Citation(s):

Chesnut CH, III. Osteoporosis and its treatment. N Engl J Med 1992 Feb 6 326 406-408.

• Medline abstract (Free)

Tilyard MW et al. Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med 1992 Feb 6 326 357-362.

• Medline abstract (Free)