Treatment of Glucocorticoid-Induced Osteoporosis with Alfacalcidol/Calcium Versus Vitamin D/Calcium

Ringe, J. D.; Cöster, A.; Meng, Tong; Schacht, E.; Umbach, Roland

doi:10.1007/s002239900708

Cited by 64 publications

(32 citation statements)

References 23 publications

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“…In the appendicular skeleton, treatment with active vitamin D had less effect than on the axial skeleton, which, in keeping with the findings of others (21), may be related to fact that trabecular bone (predominantly present in lumbar spine) is more active and responds faster than cortical bone (mainly present in distal radius). Our results confirmed the significant positive effect of active vitamin D on bone loss reported in short-term studies of nontransplant steroid-treated patients (19), nonrenal transplant recipients (20), and in renal transplant recipients (28).…”

Section: Discussionsupporting

confidence: 85%

Preventing Bone Loss in Renal Transplant Recipients with Vitamin D

El‐Agroudy

El-Husseini

El‐Sayed

et al. 2003

Journal of the American Society of Nephrology

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Abstract. Very rapid bone loss, osteopenia, and osteoporosis have been documented in the first 6 to 12 mo after renal transplantation. Investigated was the effect of treatment with active vitamin D on the prevention of posttransplantation bone loss. Forty adult men who were recent renal transplant recipients were enrolled onto the study. Patients were randomized into two groups: group 1 received daily alfacalcidol 0.5 g by mouth, and group 2 (control) received placebo. Every patient in both groups received daily 500-mg calcium carbonate supplements. Parameters of bone metabolism and bone mineral density measured at three sites were assessed before and after the study period. Bone mineral density was increased by 2.1%, 1.8%, and 3.2% at lumbar spine, femoral neck, and forearm, respectively, in group 1, whereas it decreased by 3.2%, 3.8%, and 1.8% at the same sites in the control group (P Ͻ 0.05). Serum intact parathyroid hormone level decreased significantly in group 1 compared with the control group (P ϭ 0.003). Early bone loss that occurs during the first 1 yr after renal transplantation could be prevented by alfacalcidol. Use of alfacalcidol early after transplantation is safe and well tolerated.

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Section: Discussionsupporting

confidence: 85%

Preventing Bone Loss in Renal Transplant Recipients with Vitamin D

El‐Agroudy

El-Husseini

El‐Sayed

et al. 2003

Journal of the American Society of Nephrology

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“…After 1 year of treatment with 1-hydroxycholecalciferol (alfacalcidol) there was an improvement in BMD compared to the non-treated control group. These results are in agreement with many other studies, which could demonstrate substantial improvement of bone mass after transplantation (27)(28)(29)(30)(31). The high percentage of patients with mildly elevated PTH and alkaline phosphatase levels may be related to persistence of secondary hyperparathyroidism, which started prior to transplantation and present in some patients with mildly impaired graft function.…”

Section: Discussionsupporting

confidence: 92%

A Prospective Randomized Study for the Treatment of Bone Loss with Vitamin D During Kidney Transplantion in Children and Adolescents

El‐Husseini¹,

El‐Agroudy

El‐Sayed

et al. 2004

American Journal of Transplantation

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The effect of treatment with alfacalcidol on posttransplantation bone loss in children and adolescents was investigated.Of the 63 young patients who received renal transplant and were subjected to dual-energy x-ray absorptiometry (DEXA), 30 patients had low-bone mineral density (BMD) (z-score ≤ −1) and were enrolled into the study. Their mean age at the time of transplantation was 14.5 ± 4.0 years and the mean duration after transplantation was 48 ± 34 months. Patients with low BMD were randomized into two equal homogeneous groups: group 1 (control) received placebo and group 2 received daily alfacalcidol 0.25 lg by mouth. Parameters of bone metabolism (intact parathyroid hormone, serum osteocalcin and urinary deoxypyridinoline) and BMD were assessed before and after the study period.After 12 months of treatment BMD at the lumber spine decreased from −2.2 to −2.5 in group 1 while it increased from −2.1 to −0.6 in group 2 (p < 0.001). Serum intact parathyroid hormone level decreased significantly in group 2 (p = 0.042). Apart from transient hypercalcemia in 1 patient in group 2, no other significant adverse effects were noted. This study suggested the value of alfacalcidol in the treatment of bone loss in young renal transplant recipients.

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“…5,65,66 Until recently, effects on fracture risk have not been well studied. Treatments proposed include bisphosphonates, hormone replacement therapy (HRT), vitamin D (cholecalciferol or calciferol) and calcium, calcitriol, calcidiol, alfacalcidol, calcitonin, fluoride, testosterone and anabolic steroids.…”

Section: Treatment and Treatment Thresholdsmentioning

confidence: 99%

“…5,25,65,67,69,70,224 Under most of these guidelines, patients taking glucocorticoids should be considered for treatment where BMD is found to be below a given threshold, such as the threshold for osteoporosis. If, as has been shown in the present report, the risk of fracture with the use of corticosteroids is not wholly dependent on BMD, then fracture risk assessment should take into account the independent risk associated with glucocorticoids and a history of prior fracture.…”

Section: Intervention Strategiesmentioning

confidence: 99%

Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis

Kanis¹,

Stevenson²,

McCloskey³

et al. 2007

Health Technol Assess

134

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Treatment of Glucocorticoid-Induced Osteoporosis with Alfacalcidol/Calcium Versus Vitamin D/Calcium

Cited by 64 publications

References 23 publications

Preventing Bone Loss in Renal Transplant Recipients with Vitamin D

Preventing Bone Loss in Renal Transplant Recipients with Vitamin D

A Prospective Randomized Study for the Treatment of Bone Loss with Vitamin D During Kidney Transplantion in Children and Adolescents

Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis

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