Can the Fast Bone Loss in Osteoporotic and Osteopenic Patients be Stopped with Active Vitamin D Metabolites? Dambacher, M. A. Kranich, M., Schacht, E., Neff, M. Calcified Tissue International 1997 60:115-118
The aim of this study was to evaluate whether fast trabecular bone loss in osteoporotic and osteopenic patients can effectively be treated with active vitamin D metabolites. Thirty-one osteoporotic and osteopenic patients were monitored between 4 and 22 months before and between 8 and 18 months during the treatment. Fast bone losers were designated as osteoporotic or osteopenic patients with a loss of trabecular bone density in the radius of 3% or more calculated for 1 year. For this differentiation, the high precise peripheral quantitative computed tomography system (DENSISCAN 1000) was used (reproducability 0.3% in mixed collectives). The pretreatment loss and the ``gain'' under treatment with active vitamin D metabolites was calculated for 1 year. The treatment consisted of either 0.5 mug calcitriol daily or 1 mug of alfacalcidol daily. Before treatment, the trabecular bone loss in the radius/year was -6.6 ± 0.5% (mean ± SEM). After treatment with vitamin D metabolites, the trabecular bone gain in the radius/year was 0.01 ± 0.6% (mean ± SEM). The difference was highly significant (P < 0.001). In contrast to this, the loss of cortical bone density before treatment was -1.8 ± 0.3% (mean ± SEM) and the reduced loss after treatment -0.2 ± 0.4% (mean ± SEM), both values calculated for 1 year. This difference was less significant (P < 0.05). This study shows that the treatment with active vitamin D metabolites is very effective in slowing fast trabecular bone loss in osteoporotic and osteopenic patients.