Effect of a Loading Dose of Vitamin D3 in Frail Elderly Patients with Insufficient 25‐Hydroxyvitamin D Serum Levels

Deschasse, Guillaume; Chavanne, D.; Dardaine-Giraud, VÃ©ronique; Constans, T.

doi:10.1111/j.1532-5415.2009.02530.x

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…This lack of dose predictability is highlighted in a recent letter to the editor in which the authors found considerable variability in 25(OH)D level increases among patients taking a loading dose of cholecalciferol 200,000 IU followed by 800 IU/day. 11 Thus, in clinical practice, vitamin D dosing to reach sufficiency may be analogous to warfarin dosing: it is too unpredictable to not monitor 25(OH)D concentrations.…”

Section: Discussionmentioning

confidence: 99%

Monitoring Vitamin D Concentrations in Patients with Osteoporosis: A Clinical Perspective

Linnebur¹,

Griend²,

Wallace

2010

Pharmacotherapy

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Section: Discussionmentioning

confidence: 99%

Monitoring Vitamin D Concentrations in Patients with Osteoporosis: A Clinical Perspective

Linnebur¹,

Griend²,

Wallace

2010

Pharmacotherapy

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“…A quick repletion is needed in the presence of symptoms of vitamin D deficiency (i.e., osteomalacia) and/or values of 25(OH)D < 10 ng/mL (25 nmol/L), as well as in patients eligible for treatment with potent antiresorptives with rapid and prolonged effect on bone resorption, such as intravenous bisphosphonates and denosumab. In this setting, the use of higher loading dosages allows the serum levels of 25(OH)D to be normalized within a few weeks [ 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 ].…”

Section: Methodsmentioning

confidence: 99%

Definition, Assessment, and Management of Vitamin D Inadequacy: Suggestions, Recommendations, and Warnings from the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)

Bertoldo

Cianferotti

Monaco³

et al. 2022

Nutrients

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In the recent years, both the prescriptions of serum 25(OH)D levels assay, and vitamin D supplementation are constantly increasing, as well as the costs to be incurred relating to these specific aspects. As in many other countries, the risk of vitamin D deficiency is particularly high in Italy, as recently confirmed by cohort studies in the general population as well as in patients with metabolic bone disorder. Results confirmed the North-South gradient of vitamin D levels described among European countries, despite the wide use of supplements. Although vitamin D supplementation is also recommended by the Italian Medicine Agency for patients at risk for fragility fracture or for initiating osteoporotic medication, the therapeutic gap for osteoporosis in Italy is very high. There is a consistent proportion of osteoporotic patients not receiving specific therapy for osteoporosis following a fragility fracture, with a poor adherence to the recommendations provided by national guidelines and position paper documents. The failure or inadequate supplementation with vitamin D in patients on antiresorptive or anabolic treatment for osteoporosis is thought to further amplify the problem and exposes patients to a high risk of re-fracture and mortality. Therefore, it is important that attention to its possible clinical consequences must be given. Thus, in light of new evidence from the literature, the SIOMMMS board felt the need to revise and update, by a GRADE/PICO system approach, its previous original recommendations about the definition, prevention, and treatment of vitamin D deficiency in adults, released in 2011. Several key points have been here addressed, such as the definition of the vitamin D status: normality values and optimal values; who are the subjects considered at risk of hypovitaminosis D; opportunity or not of performing the biochemical assessment of serum 25(OH)D levels in general population and in subjects at risk of hypovitaminosis D; the need or not to evaluate baseline serum 25(OH)D in candidate subjects for pharmacological treatment for osteoporosis; how and whether to supplement vitamin D subjects with hypovitaminosis D or candidates for pharmacological treatment with bone active agents, and the general population; how and whether to supplement vitamin D in chronic kidney disease and/or chronic liver diseases or under treatment with drugs interfering with hepatic metabolism; and finally, if vitamin D may have toxic effects in the subject in need of supplementation.

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“…Il n'y a pas de réponse consensuelle à ce jour. Une dose de charge de Vit D2 de 200 000 UI suivie de 800 UI/j de Vit D3 pendant un mois ne fait remonter le taux circulant de 25-OH D au-dessus de 75 nmol/l que chez 25 % des patients âgés [15]. Un protocole très utilisé actuellement en France est celui proposé par Souberbielle et al [12], eux-mêmes inspirés des propositions de Holick [1].…”

Section: Prescriptionunclassified

Indications et modalités de prescription de la vitamine D et du calcium

Constans

Deschasse

Chavanne

2009

cah. année gerontol.

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Les déficits en calcium et en vitamine D sont impliqués dans la genèse de l'ostéoporose, sans pour autant expliquer toute la pathogenèse de la maladie. Les études d'observation et d'intervention ont démontré l'effet béné-fique des suppléments de calcium et/ou de vitamine D sur la perte osseuse et la réduction des chutes et des fractures chez la personne âgée. Les recommandations actuelles pour les apports en calcium (1 200 mg/j) semblent suffisantes dans tous les pays. En revanche, les études récentes suggèrent que les recommandations actuelles pour la vitamine D (800 UI/j) sont insuffisantes non seulement chez les personnes vivant en institution, mais aussi chez les personnes âgées vivant à domicile. Des doses plus élevées de vitamine D (de préférence D3) devraient faire l'objet de recherches à venir afin d'optimiser le traitement préventif des fractures ostéoporotiques.Mots clés Ostéoporose · Fractures · Calcium · Vitamine D · Cholécalciférol · 25-hydroxyvitamine D · Personnes âgées Abstract Deficiency in both calcium and vitamin D appears to be strongly implicated in the pathogenesis of osteoporosis, without accounting for the totality of the problem. The observational or interventional studies on the relationship between calcium and/or vitamin D status and bone health show a reduction in bone loss and risks of falls and fractures in the elderly. Recommendations for calcium intake (1,200 mg per day) seem currently adequate in all countries. However, much evidence suggests that the recommendations for vitamin D (800 IU per day) are inadequate as well as in geriatric institutions and the community. Higher dose of vitamin D (preferentially cholecalciferol) should be explored in future research to optimize the preventive treatment of osteoporotic fractures.

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Effect of a Loading Dose of Vitamin D3 in Frail Elderly Patients with Insufficient 25‐Hydroxyvitamin D Serum Levels

Cited by 6 publications

References 6 publications

Monitoring Vitamin D Concentrations in Patients with Osteoporosis: A Clinical Perspective

Monitoring Vitamin D Concentrations in Patients with Osteoporosis: A Clinical Perspective

Definition, Assessment, and Management of Vitamin D Inadequacy: Suggestions, Recommendations, and Warnings from the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)

Indications et modalités de prescription de la vitamine D et du calcium

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