Osteoporosis treatment with denosumab is helped by Vitamin D and Calcium – 2017

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Vitamin D and calcium are required at the time of denosumab administration during osteoporosis treatment Oct 2017

Bone Res. 2017 Oct 10;5:17021. doi: 10.1038/boneres.2017.21. eCollection 2017.

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Nakamura Y1,2, Suzuki T1, Kamimura M3, Murakami K1, Ikegami S1, Uchiyama S1, Kato H1.
1 Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
2 Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Japan.
3 Center of Osteoporosis and Spinal Disorders, Kamimura Orthopaedic Clinic, Matsumoto, Japan.

To evaluate the differences in outcomes of treatment with denosumab alone or denosumab combined with vitamin D and calcium supplementation in patients with primary osteoporosis. Patients were split into a denosumab monotherapy group (18 cases) or a denosumab plus vitamin D supplementation group (combination group; 23 cases). We measured serum bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRACP)-5b and urinary N-terminal telopeptide of type-I collagen (NTX) at baseline, 1 week, as well as at 1 month and 2, 4, 8 and 12 months. We also measured bone mineral density (BMD) of L1-4 lumbar vertebrae (L)-BMD and bilateral hips (H)-BMD at baseline and at 4, 8 and 12 months. There was no significant difference in patient background. TRACP-5b and urinary NTX were significantly suppressed in both groups from 1 week to 12 months (except at 12 months for NTX). In the combination group, TRACP-5b was significantly decreased compared with the denosumab monotherapy group at 2 and 4 months (P<0.05). BAP was significantly suppressed in both groups at 2-12 months. L-BMD significantly increased at 8 and 12 months (8.9%) in the combination group and at 4, 8 and 12 months (6.0%) in the denosumab monotherapy group, compared with those before treatment. H-BMD was significantly increased in the combination group (3.6%) compared with the denosumab group (1.2%) at 12 months (P<0.05). Compared with denosumab monotherapy, combination therapy of denosumab with vitamin D and calcium stopped the decrease in calcium caused by denosumab, inhibited bone metabolism to a greater extent, and increased BMD (especially at the hips).

PMID: 29021920 PMCID: PMC5634512 DOI: 10.1038/boneres.2017.21

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They used a very small amount of Vitamin D (400 IU daily)

• "762.5 mg of precipitated calcium carbonate, 200 IU of cholecalciferol, 59.2 mg of magnesium carbonate) twice daily to all patients after denosumab administration"
• Imagine the increase in bone density if they had used a lot of Vitamin D, Magnesium, Silicon, Boron and Vitamin K which are needed to build bones

See VitaminDWiki

• Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
• Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
• Vitamin K and bone – review Oct 2017

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Vitamin D and Calcium Are Required during Denosumab Treatment in Osteoporosis with Rheumatoid Arthritis - April 2017

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