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KMID : 0356620100250040305
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Journal of Korean Society of Endocrinology
2010 Volume.25 No. 4 p.305 ~ p.309
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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
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Koo Jee-Hoon
Kim Hyun-Kyung
Kim In-Sung
Kim Eun-Kyung
Chung Yoon-Sok
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Abstract
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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® (alendronate 5 mg plus calcitriol 0.5 μg) daily or Fosamax Plus® (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® group (n = 45), the serum PTH significantly decreased by 17% from baseline at 6 months (μd = -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® group (n = 27), the serum 25(OH)D significantly increased by 77% from baseline at 3 months (μd = 9.87; ± 2.32 SE; P < 0.05) and it remained significantly higher than baseline at 6 months (μd = 3.49; ± 0.86 SE; P < 0.05) and 12 months (μd = 10.47; ± 0.71 SE; P < 0.001). However, the serum PTH showed no significant decrease. In the Maxmarvil® group, the serum osteocalcin significantly decreased by 26% from baseline at 12 months (μd = -5.15; ± 0.35 SE; P < 0.05), and in the Fosamax Plus® group, the serum osteocalcin significantly decreased by 19% from baseline at 6months (μd = -2.64; ± 0.73 SE; P < 0.05) and it remained suppressed to 12 months (μd = -2.99; ± 0.37 SE; P = 0.32) without significance.
Conclusion: Maxmarvil® and Fosamax Plus® both improved the bone metabolism in Korean osteoporosis patients. Maxmarvil® significantly lowered the serum PTH levels, whereas Fosamax Plus® significantly elevated the serum 25(OH)D levels.
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KEYWORD
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Calcitriol, Cholecalciferol, Bisphosphonates, Bone metabolism
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