The Effects of Combined Treatment of Alendronate Plus Active or Plain Vitamin D on the Vitamin D Metabolism and Bone Turnover Markers in Patients with Osteoporosis

Received: 17 October 2009, Accepted: 10 August 2010 Corresponding author: Yoon-Sok Chung Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 443-479, Korea Tel: +82-31-219-5127, Fax: +82-31-219-4497, E-mail: [email protected] Background: The purpose of this study was to evaluate the effects of combined treatment with alendronate plus active or plain vitamin D on the vitamin D metabolism and bone turnover markers in patients with osteoporosis. Methods: We investigated 297 osteoporosis outpatients who were treated with Maxmarvil (alendronate 5 mg plus calcitriol 0.5 μg) daily or Fosamax Plus (alendronate 70 mg plus cholecalciferol 2,800 IU) weekly for 1 year. The serum levels of 25(OH)D, parathyroid hormone (PTH), calcium, phosphorus, osteocalcin and N-telopeptide were measured at baseline and after 3, 6, and 12 months of treatment. Results: The data of 72 of the 297 patients were analyzed. In the Maxmarvil group (n = 45), the serum PTH significantly decreased by 17% from baseline at 6 months (μd = -6.10; ± 0.85 SE; P < 0.05) and it remained suppressed to 12 months. The serum 25(OH)D tended to increase, but without significance. In the Fosamax Plus group (n = 27), the serum 25(OH)D significantly increased by 77% from baseline at 3 months (μd = 9.87; ± 2.32 SE; P < 0.05) and it remained significantly higher than baseline at 6 months (μd = 3.49; ± 0.86 SE; P < 0.05) and 12 months (μd = 10.47; ± 0.71 SE; P < 0.001). However, the serum PTH showed no significant decrease. In the Maxmarvil group, the serum osteocalcin significantly decreased by 26% from baseline at 12 months (μd = -5.15; ± 0.35 SE; P < 0.05), and in the Fosamax Plus group, the serum osteocalcin significantly decreased by 19% from baseline at 6months (μd = -2.64; ± 0.73 SE; P < 0.05) and it remained suppressed to 12 months (μd = -2.99; ± 0.37 SE; P = 0.32) without significance. Conclusion: Maxmarvil and Fosamax Plus both improved the bone metabolism in Korean osteoporosis patients. Maxmarvil significantly lowered the serum PTH levels, whereas Fosamax Plus significantly elevated the serum 25(OH)D levels. (Endocrinol Metab 25:305-309, 2010)