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KMID : 1120320210070020047
Osteoporosis and Sarcopenia
2021 Volume.7 No. 2 p.47 ~ p.53
Comparative effect of eldecalcitol and alfacalcidol on bone microstructure: A preliminary report of secondary analysis of a prospective trial
Ni Xiaolin

Feng Juan
Jiang Yan
Zhang Li
Yu Wei
Wang Ou
Li Mei
Xing Xiaoping
Matsumoto Toshio
Xia Weibo
Abstract
Objectives: To compare the effect of eldecalcitol and alfacalcidol on skeletal microstructure by high-resolution peripheral QCT (HR-pQCT).

Methods: This was a substudy of a randomized, double-blind, active comparator trial. Five female osteoporotic patients with 1-year 0.75 ¥ìg/day eldecalcitol and 5 with 1-year 1.0 ¥ìg/day alfacalcidol completed HR-pQCT scans before and after treatment were enrolled.

Results: Total vBMD [1.67 ¡¾ 1.06% (mean ¡¾ SD), P = 0.043 versus baseline] and trabecular vBMD (2.91 ¡¾ 1.72%, P = 0.043) at the radius increased in eldecalcitol group, while total, trabecular, and cortical vBMD tended to decrease in alfacalcidol group, with a significant reduction in cortical vBMD at the tibia (0.88 ¡¾ 0.62%, P = 0.043). Cortical area (1.82 ¡¾ 1.92%, P = 0.043) at the radius and thickness (0.87 ¡¾ 1.12%, P = 0.043) at the tibia increased in eldecalcitol group, while these parameters decreased with alfacalcidol at the tibia (1.77 ¡¾ 1.72%, P = 0.043 for cortical area; 1.40 ¡¾ 2.14%, P = 0.042 for cortical thickness). Trabecular thickness at the radius (1.97 ¡¾ 1.93%, P = 0.042) and number at the tibia (3.09 ¡¾ 3.04%, P = 0.043) increased by eldecalcitol but did not increase by alfacalcidol. Trabecular separation decreased by eldecalcitol (2.22 ¡¾ 2.43%, P = 0.043) but tended to increase by alfacalcidol at the tibia.

Conclusions: Eldecalcitol has the greater potential to improve cortical and trabecular microstructure at the peripheral bone than alfacalcidol which needs further more studies.
KEYWORD
Osteoporosis, Eldecalcitol, Alfacalcidol, High-resolution peripheral QCT, Bone microstructure
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