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Poor response to Osteoporosis medicine (risedronate) if vitamin D less than 16 ng – May 2018

Factors associated with inadequate responses to risedronate in Japanese patients with osteoporosis.

J Bone Miner Metab. 2018 May 8. doi: 10.1007/s00774-018-0931-2. [Epub ahead of print]
Okazaki R1, Muraoka R2, Maehara M2, Inoue D3.
1 Third Department of Medicine, Teikyo University Chiba Medical Center Japan, 3426-3, Anesaki, Ichihara-shi, Chiba, 299-0111, Japan. rokazaki at med.teikyo-u.ac.jp.
2 EA Pharma Co., Ltd., Tokyo, Japan.
3 Third Department of Medicine, Teikyo University Chiba Medical Center Japan, 3426-3, Anesaki, Ichihara-shi, Chiba, 299-0111, Japan.


Overview Osteoporosis and vitamin D contains the following summary

  • FACT: Bones need Calcium (this has been known for a very long time)
  • FACT: Vitamin D improves Calcium bioavailability (3X ?)
  • FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
  • FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
  • FACT: Vitamin D supplements are very low cost
  • FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
  • FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
  • FACT: Co-factors help build bones.
  • FACT: Vitamin D Receptor can restrict Vitamin D from getting to many tissues, such as bones
  • It appears that to TREAT Osteoporosis:
  •        Calcium OR vitamin D is ok
  •        Calcium + vitamin D is good
  •        Calcium + vitamin D + other co-factors is great
  •        Low-cost Vitamin D Receptor activators sometimes may be helpful
  • CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
  • Category Osteoporosis has 210 items
  • Category Bone Health has 300 items

Note: Osteoporosis causes bones to become fragile and prone to fracture
  Osteoarthritis is a disease where damage occurs to the joints at the end of the bones

Osteoporosis category includes the following

Factors associated with an inadequate response (IR) to bisphosphonates have been reported in many countries, but not in Japan, where the approved dose is half the global dose. We analyzed factors associated with IR to risedronate in Japanese patients with osteoporosis. This was a post hoc analysis of 1261 Japanese osteoporosis patients who received risedronate for 1 year in phase III trials. IR was defined as more than one new vertebral fracture (VF) and/or negative change in lumbar spine bone mineral density (BMD) at 1 year. Various baseline and follow-up variables were examined for potential contribution to IR. Of the 1261 subjects, 118 exhibited an IR. At baseline, IR was associated with a higher BMD, lower levels of bone turnover markers (BTM) (serum bone-specific alkaline phosphatase, urinary N-terminal telopeptide of type 1 collagen and C-terminal telopeptide of type 1 collagen), and serum 25-hydroxyvitamin D [25(OH)D] below 16 ng/mL.
BTM changes were blunted at 6 months in subjects with IR. On simple regression analysis, all the above variables and poor drug adherence were associated with an IR. On multivariate regression analysis, factors associated with IR were high BMD, vitamin D deficiency at baseline and low BTM at baseline, or a decreased BTM response at 6 months.
Low serum 25(OH)D and BTM as well as high BMD at baseline were independent predictors of an IR to risedronate in Japan. These results emphasize the importance of the assessment of serum 25(OH)D and BTM in the management of osteoporosis with bisphosphonates.

PMID: 29737412 DOI: 10.1007/s00774-018-0931-2

Created by admin. Last Modification: Wednesday May 9, 2018 13:49:28 GMT-0000 by admin. (Version 2)