Eldecalcitol, in Combination with Bisphosphonate, Is Effective for Treatment of Japanese Osteoporotic Patients

Abstract

Alfacalcidol (ALF) and eldecalcitol (ELD) are vitamin D analogues that can be combined with anti-resorption drugs, such as bisphosphonate (BP) for the treatment of osteoporosis (OP). There has been no report comparing the effects of those vitamin D analogs in combination with BPs. Twenty female patients with OP were enrolled, and all of them were treated with ALF and BPs. After switching from ALF to ELD, we examined the effectiveness of ALF and ELD. The averaged age was 69.4 years and the period of BP usage was between 1 to 13.4 years (mean period was 3.7 years). Serum corrected calcium, serum inorganic phosphorus, serum bone specific alkaline phosphatase (BAP), and serum tartrate-resistant acid phosphatase (TRACP)-5b were measured prior to ELD and at 6 months afterwards. Bone mineral density (BMD) of the lumbar spine (L-BMD), femoral neck, and total hip BMD were assessed one year before, prior to, and one year after ELD therapy commencement. Six months after switching from ALF to ELD, BAP and TRACP-5b values significantly decreased. After one year of ALF therapy, L-BMD, total hip BMD and femoral neck H-BMD values slightly increased. In contrast, a year following the change from ALF to ELD, L-BMD significantly increased and femoral neck BMD slightly increased, but total hip BMD did not. These results suggest that the treatment with ELD after ALF significantly suppressed bone turnover and increased L-BMD. Thus, the combined therapy with ELD is more effective for OP treatment than that with ALF.

Efficacy of Denosumab for Osteoporosis in Two Patients with Adult-Onset Still’s Disease—Denosumab Efficacy in Osteoporotic Still’s Disease Patients

“…In this study, a 0.9% increase of FN-BMD with ELD at six months in Case 1 and a 2.4% gain in FN-BMD without ELD at four months in Case 2 were observed during denosumab therapy. Nonetheless, a combination therapy of anti-resorption drugs and vitamin D, such as ELD, may produce better effects on bone metabolism and BMD, as reported previously [ 17 , 18 ].…”

“…Vitamin D is required for optimal BMD increase during denosumab treatment [ 16 ]. ELD, an analog of active vitamin D3, could improve BMD and reduce the risk of osteoporotic fractures [ 17 ]. We previously reported that a combination therapy with denosumab and ELD ameliorated FN-BMD more effectively than did denosumab plus native vitamin D [ 18 ].…”

Resistance training programs on bone related variables and functional independence of postmenopausal women in pharmacological treatment: A randomized controlled trial

“…The drug therapy with bisphosphonate is recommended and safe for beneficial effects on bone health in postmenopausal women, especially, when there is an increased risk of fracture in hip and lumbar spine (Diab & Watts, 2013;Reginster, 2011). According to a study of Mukaiyama et al (2015) the combined effect of alendronate with alfacalcidol and eldecalcitol (analogous to vitamin D), showed significant improvement in BMD of the lumbar spine, maintenance the femur neck and showed no improvement in hip BMD after one year of treatment.…”

“…In the GC not was observed increase BMD (p < 0.05) in the variables, characterized as a BMD maintenance. Although the drug was not analyzed as an independent variable, it was likely that the drug can have contributed to the increase or maintenance of the BMD, because, there is evidence that a combination of PA with alendronate shows positive effects on BMD (Mukaiyama et al, 2015;Uusi-Rasi et al, 2003). Therefore, together, alendronate and PA can be more efficient in reducing the risk of fracture (Borba-Pinheiro et al, 2010;Uusi-Rasi et al, 2003).…”

Alfacalcidol Increases the Therapeutic Efficacy of Ibandronate on Bone Mineral Density in Japanese Women with Primary Osteoporosis

“…Combination therapy of a BP and ALF is frequently used for Japanese patients with OP since ALF has been approved as an osteoporotic drug. However, there are few reports on combined therapy using a BP and ALF, and the precise effects of ALF on BP treatment for OP is controversial (Iwamoto et al 2003;Ringe et al 2007;Orimo et al 2011;Mukaiyama et al 2015). Furthermore, little is known on the role of ALF during IBN treatment in patients with OP.…”