Journal Article

Effects of a combined alendronate and calcitriol agent (Maxmarvil®) on bone metabolism in Korean postmenopausal women: a multicenter, double-blind, randomized, placebo-controlled study

Lim, S.-K., Chung, Y., Mok, J., Byun, D., Baek, K., Ahn, C., Kim, Y., Kang, M., Min, Y., Kim, D., Rhee, Y., Myoung, S., Kim, H.

2006

Overview

A randomized, double-blind, prospective, 24-week clinical trial was performed to evaluate the effects of a combinative agent, Maxmarvil, of calcitriol (0.5 mug) and alendronate (5 mg) on bone metabolism in postmenopausal women. A total of 217 postmenopausal women with osteoporosis were enrolled; 199 patients were randomly assigned to one of two treatment groups (Maxmarvil group or alfacalcidol group). None of the patients were vitamin-D-deficient, as assessed by serum 25-hydroxyvitamin D (25(OH)D), nor had they received any drugs affecting bone metabolism before enrollment. Bone mineral densities (BMD) of L1-L4 and the femur were measured by dual-energy X-ray absorptiometry (DXA) at the initial assessment and after 6 months of treatment. Serum biochemical assays, including serum calcium, 24-h urinary calcium excretion, and bone turnover markers (both bone-specific alkaline phosphatase [bsALP] and urine N-telopeptide [NTx]), were performed at the baseline and after 3 and 6 months of treatment. In the Maxmarvil group, the BMD of the lumbar spine increased up to 2.42+/-0.5% from the baseline after 6 months (p<0.05). On the other hand, the change in BMD in the alfacalcidol group was 0.28+/-0.5% after 6 months. There was no significant difference in femoral BMD between the two groups. The levels of bsALP and NTx were significantly lower in the Maxmarvil group than in the alfacalcidol group (-22.04+/-3.9% vs. -11.42+/-2.8% [p<0.05] and -25.46+/-5.2% vs. 1.24+/-6.2% [p<0.001], respectively). Interestingly, there was a significantly smaller amount of 24-h urinary calcium in the Maxmarvil group (p<0.05). Our study demonstrates that a combination of calcitriol and alendronate is quite effective in preventing bone loss, with the advantage of lesser hypercalciuric effect of calcitriol in the postmenopausal osteoporotic women.

• Publisher: Springer,Springer Nature B.V
• Subject: Alendronate - adverse effects / Alendronate - therapeutic use / Alkaline Phosphatase - blood / Biological and medical sciences / Biomarkers - analysis / Bone density / Bone Density - physiology / Bone Density Conservation Agents - adverse effects / Bone Density Conservation Agents - therapeutic use / Bones, joints and connective tissue. Antiinflammatory agents / Calcitriol - adverse effects / Calcitriol - therapeutic use / Calcium / Clinical trials / Collagen Type I - urine / Diseases of the osteoarticular system / Double-Blind Method / Drug Combinations / Drug therapy / Female / Femur - metabolism / Humans / Hydroxycholecalciferols - adverse effects / Hydroxycholecalciferols - therapeutic use / Korea - epidemiology / Lumbar Vertebrae - metabolism / Medical sciences / Metabolism / Middle Aged / Older people / Osteoporosis, Postmenopausal - drug therapy / Osteoporosis, Postmenopausal - epidemiology / Osteoporosis, Postmenopausal - metabolism / Osteoporosis. Osteomalacia. Paget disease / Peptides - urine / Pharmacology. Drug treatments / Treatment Outcome / Women