Comparison of Calcitriol Treatment with Etidronate–Calcitriol and Calcitonin–Calcitriol Combinations in Turkish Women with Postmenopausal Osteoporosis: A Prospective Study |
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Authors: | A Gürlek M Bayraktar O Gedik |
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Institution: | (1) Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology, 06100-Ankara, Turkey, TR |
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Abstract: | Calcitriol has been widely used in the management of osteoporosis, but its efficiency is a matter of controversy. It is not
known whether combinations of calcitriol and antiresorptive agents such as etidronate and calcitonin are superior to calcitriol
alone in the treatment of postmenopausal osteoporosis. To make this determination, 30 Turkish women with postmenopausal osteoporosis
between 45 and 68 years of age were randomized to receive either intermittent cyclical etidronate (400 mg/day, for 14 days)
followed by 60 days of cyclical calcitriol therapy 0.25 μg twice daily (group 1; n= 10), or calcitriol 0.25 μg twice daily (group 2; n= 10), or calcitriol 0.25 μg/day in combination with 100 IU intranasal salmon calcitonin taken every other day (group 3; n= 10) through a 1-year period. Bone mineral density (BMD) of lumbar spine (L2 to L4) was determined for each patient by dual-photon
absorptiometry (153Gd) at baseline, after 6 months, and at the end of the study. There was no significant difference among groups with respect
to mean spinal BMD at baseline, after 6, and after 12 months. No significant spinal BMD changes occurred in any group from
baseline, after 6 months, and after 12 months. Four patients in groups 1 and 2 and five patients in group 3 developed hypercalcemia
at least once during therapy. Hypercalciuria occurred at least once in 9, 10, and 7 patients in groups 1, 2, and 3, respectively.
One patient in group 2 developed a renal stone at the end of the study. Mean urine hydroxyproline levels did not change significantly
in any group with respect to baseline. The data suggest that one-year treatment with calcitriol, given either alone or in
combination with antiresorptive agents, does not improve spinal BMD in Turkish women with postmenopausal osteoporosis, and
is associated with a high rate of adverse events.
Received: 4 October 1996 / Accepted: 31 December 1996 |
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Keywords: | : Spinal bone mineral density — Calcitonin — Calcitriol — Etidronate — Postmenopausal osteoporosis |
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