Eldecalcitol is superior to alfacalcidol in maintaining bone mineral density in glucocorticoid-induced osteoporosis patients (e-GLORIA)
| Autor: | Tsutomu Takeuchi, Kazuhiko Yamamoto, Toshio Matsumoto, Satoshi Soen, Akihiro Hirakawa, Yoshiya Tanaka, Sakae Tanaka, Tatsushi Tomomitsu, Tetsuo Nakano, Masako Ito |
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| Rok vydání: | 2020 |
| Předmět: |
Male
musculoskeletal diseases 0301 basic medicine medicine.medical_specialty Endocrinology Diabetes and Metabolism Osteoporosis Urology 030209 endocrinology & metabolism Kaplan-Meier Estimate 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology Bone Density medicine Humans Orthopedics and Sports Medicine Vitamin D Adverse effect Glucocorticoids Bone mineral Hip Lumbar Vertebrae Bone Density Conservation Agents Femur Neck Hydroxycholecalciferols business.industry Alfacalcidol General Medicine Middle Aged Eldecalcitol medicine.disease chemistry Orthopedic surgery Spinal Fractures Female Bone Remodeling 030101 anatomy & morphology Secondary osteoporosis business Biomarkers Glucocorticoid medicine.drug |
| Zdroj: | Journal of Bone and Mineral Metabolism. 38:522-532 |
| ISSN: | 1435-5604 0914-8779 |
| DOI: | 10.1007/s00774-020-01091-4 |
| Popis: | Eldecalcitol increases bone mineral density (BMD) and reduces vertebral fracture in patients with primary osteoporosis. However, the effect of eldecalcitol on BMD and fracture in glucocorticoid-induced osteoporosis (GIO) patients is unknown. This study was undertaken to compare the effect of eldecalcitol on BMD and fracture with that of alfacalcidol in GIO patients.A randomized, open-label, parallel group study was conducted to identify the effectiveness and safety of monotherapy with 0.75 μg eldecalcitol compared with 1.0 μg alfacalcidol in GIO patients.Lumbar spine BMD increased with eldecalcitol, but decreased with alfacalcidol at 12 and 24 months (between group difference 1.29%, p 0.01, and 1.10%, p 0.05, respectively). Total hip and femoral neck BMD were maintained until 24 months by eldecalcitol, but decreased by alfacalcidol (between group difference 0.97%, p 0.05 and 1.22%, p 0.05, respectively). Both bone formation and resorption markers were more strongly suppressed by eldecalcitol than by alfacalcidol. Eldecalcitol showed better effect on BMD than alfacalcidol in patients with no prevalent fracture and BMD 70% of the young adult mean, and with ≤ 3 months of previous glucocorticoid treatment. No significant difference in the incidence of vertebral fracture was found, and the incidence of adverse events was similar between the two groups.Eldecalcitol was more effective than alfacalcidol in maintaining BMD in GIO patients. Because eldecalcitol was effective in patients with no or short-term previous glucocorticoid treatment, as well as those without prevalent fracture or low BMD, eldecalcitol can be a good candidate for primary prevention of GIO.UMIN000011700. |
| Databáze: | OpenAIRE |
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