Limits...
Management of osteoporosis with calcitriol in elderly Chinese patients: a systematic review.

Liao RX, Yu M, Jiang Y, Xia W - Clin Interv Aging (2014)

Bottom Line: It plays a role in many biological processes, especially in bone metabolism and muscle function, and is mediated by vitamin D receptors.Osteoporosis in elderly men and women is characterized by uncoupled bone remodeling, which is induced by sex hormone deficiencies, somatopause, vitamin D deficiency, reduced synthesis of D hormone, and lack of receptors or receptor affinity for D hormone in target organs.Further, calcitriol in combination with other therapeutic bone agents was shown to be well tolerated and capable of additional bone-preserving effects compared with use of calcitriol alone in areas including bone mineral density, bone turnover markers, bone pain improvement, and fracture incidence.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

ABSTRACT
Osteoporosis, a skeletal disorder characterized by a reduction in bone strength, is becoming a major public health problem in the People's Republic of China, with a rapid increase observed among the population. Chinese guidelines particularly recommend use of active vitamin D in managing osteoporosis. 1,25-(OH)2D3 (calcitriol) is an active vitamin D metabolite. It plays a role in many biological processes, especially in bone metabolism and muscle function, and is mediated by vitamin D receptors. Osteoporosis in elderly men and women is characterized by uncoupled bone remodeling, which is induced by sex hormone deficiencies, somatopause, vitamin D deficiency, reduced synthesis of D hormone, and lack of receptors or receptor affinity for D hormone in target organs. Reviewed here are six randomized controlled trials on calcitriol monotherapy and five on calcitriol therapy combined with other antiosteoporotic agents. Evidence from these trials shows that calcitriol monotherapy can improve bone mineral density in elderly osteoporotic Chinese patients but may be insufficient for long-term treatment. Calcitriol can also decrease bone turnover markers and bring about significant improvements in muscle strength. Further, calcitriol in combination with other therapeutic bone agents was shown to be well tolerated and capable of additional bone-preserving effects compared with use of calcitriol alone in areas including bone mineral density, bone turnover markers, bone pain improvement, and fracture incidence. Hypercalcemia and hypercalciuria, the most common side effects of calcitriol therapy, were not documented in the trials reviewed, and might have been the result of the low dosages used. One study showed that treatment with calcitriol can improve quality of life in patients with osteoporosis, although not to the same extent as bisphosphonates.

Show MeSH

Related in: MedlinePlus

Diagram of literature search and selection.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3974693&req=5

f1-cia-9-515: Diagram of literature search and selection.

Mentions: Initially, 468 relevant trials were identified. Following a preliminary review, 437 papers were excluded because of duplication or irrelevance. The remaining 31 trials were closely reviewed. Among them, 25 articles were excluded for the following reasons: outcome of interest not described (n=12), improper study design (n=10) and participants had coexisting medical conditions (n=3). As a result, there were six trials included in the current meta-analysis (Figure 1).


Management of osteoporosis with calcitriol in elderly Chinese patients: a systematic review.

Liao RX, Yu M, Jiang Y, Xia W - Clin Interv Aging (2014)

Diagram of literature search and selection.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3974693&req=5

f1-cia-9-515: Diagram of literature search and selection.
Mentions: Initially, 468 relevant trials were identified. Following a preliminary review, 437 papers were excluded because of duplication or irrelevance. The remaining 31 trials were closely reviewed. Among them, 25 articles were excluded for the following reasons: outcome of interest not described (n=12), improper study design (n=10) and participants had coexisting medical conditions (n=3). As a result, there were six trials included in the current meta-analysis (Figure 1).

Bottom Line: It plays a role in many biological processes, especially in bone metabolism and muscle function, and is mediated by vitamin D receptors.Osteoporosis in elderly men and women is characterized by uncoupled bone remodeling, which is induced by sex hormone deficiencies, somatopause, vitamin D deficiency, reduced synthesis of D hormone, and lack of receptors or receptor affinity for D hormone in target organs.Further, calcitriol in combination with other therapeutic bone agents was shown to be well tolerated and capable of additional bone-preserving effects compared with use of calcitriol alone in areas including bone mineral density, bone turnover markers, bone pain improvement, and fracture incidence.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

ABSTRACT
Osteoporosis, a skeletal disorder characterized by a reduction in bone strength, is becoming a major public health problem in the People's Republic of China, with a rapid increase observed among the population. Chinese guidelines particularly recommend use of active vitamin D in managing osteoporosis. 1,25-(OH)2D3 (calcitriol) is an active vitamin D metabolite. It plays a role in many biological processes, especially in bone metabolism and muscle function, and is mediated by vitamin D receptors. Osteoporosis in elderly men and women is characterized by uncoupled bone remodeling, which is induced by sex hormone deficiencies, somatopause, vitamin D deficiency, reduced synthesis of D hormone, and lack of receptors or receptor affinity for D hormone in target organs. Reviewed here are six randomized controlled trials on calcitriol monotherapy and five on calcitriol therapy combined with other antiosteoporotic agents. Evidence from these trials shows that calcitriol monotherapy can improve bone mineral density in elderly osteoporotic Chinese patients but may be insufficient for long-term treatment. Calcitriol can also decrease bone turnover markers and bring about significant improvements in muscle strength. Further, calcitriol in combination with other therapeutic bone agents was shown to be well tolerated and capable of additional bone-preserving effects compared with use of calcitriol alone in areas including bone mineral density, bone turnover markers, bone pain improvement, and fracture incidence. Hypercalcemia and hypercalciuria, the most common side effects of calcitriol therapy, were not documented in the trials reviewed, and might have been the result of the low dosages used. One study showed that treatment with calcitriol can improve quality of life in patients with osteoporosis, although not to the same extent as bisphosphonates.

Show MeSH
Related in: MedlinePlus