Active vitamin D metabolites in the therapy of menopausal osteoporosis

Kuznetsova I.V.

I.M. Sechenov First Moscow State Medical University, Moscow 119992, Malaya Trubetskaya str. 8 bld. 2, Russia
Objective. To carry out a systematic analysis of the data available in the literature on the problem of therapy with active vitamin D metabolites for menopausal osteoporosis.
Material and methods. For analysis, foreign and Russian works published in the past 15 years were sought for in the international citation system Pubmed.
Results. The modern theories of the mechanism of development of menopausal osteoporosis are described. The specific features of metabolism of vitamin D and its effects on bone tissue are depicted. International and Russian guidelines for the treatment of osteoporosis are given. The data of investigations demonstrating the possibility of using active vitamin D metabolites in the therapy of menopausal osteoporosis are analyzed.
Conclusion. The use of active vitamin D metabolites alone or in combination with bisphosphonates is an effective method with a good safety profile for treating women with menopausal osteoporosis.

Keywords

menopausal osteoporosis
bone mineral density
osteoporotic fractures
antiresorptive therapy
vitamin D
active vitamin D metabolites
α-calcidol

Supplementary Materials

  1. Table 1. Pathogenetic therapy of osteoporosis [26, 48]
  2. Table 2. Side effects with the use of active metabolites of vitamin D

References

1. Burch J.B., Augustine A.D., Frieden L.A., Hadley E., Howcroft T.K., Johnson R. et al. Advances in geroscience: impact on health span and chronic disease. J. Gerontol. A Biol. Sci. Med. Sci. 2014; 69(Suppl. 1): S1-3.

2. De Luca d’Alessandro E., Bonacci S., Giraldi G. Aging populations: the health and quality of life of the elderly. Clin. Ter. 2011; 162(1): e13-8.

3. López-Otín C., Blasco M.A., Partridge L., Serrano M., Kroemer G. The hallmarks of aging. Cell. 2013; 153: 1194-217.

4. Martin G.M. The biology of aging: 1985-2010 and beyond. FASEB J. 2011; 25(11): 3756-62.

5. Berman A.E., Leontieva O.V., Natarajan V., McCubrey J.A., Demidenko Z.N., Nikiforov M.A. Recent progress in genetics of aging, senescence and longevity: focusing on cancer-related genes. Oncotarget. 2012; 3: 1522-32.

6. Nicolson G.L. Mitochondrial dysfunction and chronic disease: treatment with natural supplements. Altern. Ther. Health Med. 2014; 20(Suppl. 1): 18-25.

7. Thorner M.O. Endocrinology of aging: the convergence of reductionist science with systems biology and integrative medicine. Front. Endocrinol. 2010; 1: 2.

8. Kanis J.A., McCloskey E.V., Johansson H., Cooper C. et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos. Int. 2013; 24: 23-57.

9. Kanis J.A.; on behalf of the WHO Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. WHO Collaborating Centre, University of Sheffield, UK; 2008.

10. Kitchin B., Morgan S.L. Not just calcium and vitamin D: other nutritional considerations in osteoporosis. Curr. Rheumatol. Rep. 2007; 9(1): 85-92.

11. Rizzoli R., Bianchi M.L., Garabedian M. et al. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010; 46: 294-305.

12. Adami S., Giannini S., Bianchi G., Sinigaglia L., Di Munno O., Fiore C.E. et al. Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos. Int. 2009; 20: 239-44.

13. Reid I.R. Relationships between fat and bone. Osteoporos. Int. 2008; 19(5): 595-606.

14. Aguilar-Chavez E.A., Gamez-Nava J.I., Lopez-Olivo M.A. et al. Circulating leptin and bone mineral density in rheumatoid arthritis. J. Rheumatol. 2009; 36(3): 512-6.

15. Lenora J., Lekamwasam S., Karlsson M.K. Effect of multiparity and prolonged breast-feeding on maternal bone mineral density: a community-based cross-sectional study. BMC Women’s Health. 2009; 9: 19.

16. Melton L.J., Kearns A.E., Atkinson E.J., Bolander M.E., Achenbach S.J., Huddleston J.M. et al. Secular trends in hip fracture incidence and recurrence. Osteoporos. Int. 2009; 20: 687-94.

17. Miura S., Nakamori M., Yagi M., Saavedra O.L., Ikemoto S., Yamamoto S. Daily calcium intake and physical activity status in urban women living on low incomes in Davao, Philippine: a primary study for osteoporosis prevention. J. Med. Invest. 2009; 56: 130-5.

18. Blake G.M., Fogelman I. Role of dual-energy X-ray absorptiometry in the diagnosis and treatment of osteoporosis. J. Clin. Densitom. 2007; 10: 102-10.

19. Lesnyak O.M., Benevolenskaya L.I. Osteoporosis. Diagnosis, prevention and treatment. Russian Association for Osteoporosis (Clinical Recommendations). Moscow: GEOTAR-Media; 2009. 269p. (in Russian)

20. Civitelli R., Armamento-Villareal R., Napoli N. Bone turnover markers: understanding their value in clinical trials and clinical practice. Osteoporos. Int. 2009; 20: 843-51.

21. Kanis J.A., McCloskey E., Johansson H., Oden A., Leslie W.D. FRAX® with and without bone mineral density. Calcif. Tissue Int. 2012; 90: 1-13.

22. Black D.M., Delmas P.D., Eastell R., Reid I.R. et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N. Engl. J. Med. 2007; 356: 1809-22.

23. Silverman S.L., Chines A.A., Kendler D.L., Kung A.W. et al. Sustained efficacy and safety of bazedoxifene in preventing fractures in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled study. Osteoporos. Int. 2012; 23: 351-63.

24. Kanis J.A., Johansson H., Oden A., McCloskey E.V. Bazedoxifene reduces vertebral and clinical fractures in postmenopausal women at high risk assessed with FRAX. Bone. 2009; 44: 1049-54.

25. Kanis J.A., Johansson H., Oden A., McCloskey E.V. A meta-analysis of the efficacy of raloxifene on all clinical and vertebral fractures and its dependency on FRAX. Bone. 2010; 47: 729-35.

26. de Villiers T.J., Chines A.A., Palacios S., Lips P. et al. Safety and tolerability of bazedoxifene in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled phase 3 trial. Osteoporos. Int. 2011; 22: 567-76.

27. Harris S.T., Blumentals W.A., Miller P.D. Ibandronate and the risk of non-vertebral and clinical fractures in women with postmenopausal osteoporosis: results of a meta-analysis of phase III studies. Curr. Med. Res. Opin. 2008; 24: 237-45.

28. Rizzoli R., Reginster J.Y., Boonen S., Breart G. Adverse reactions and drug-drug interactions in the management of women with postmenopausal osteoporosis. Calcif. Tissue Int. 2011; 89: 91-104.

29. Pazianas M., Compston J., Huang C.L. Atrial fibrillation and bisphosphonate therapy. J. Bone Miner. Res. 2010; 25: 2-10.

30. Cardwell C.R., Abnet C.C., Cantwell M.M., Murray L.J. Exposure to oral bisphosphonates and risk of esophageal cancer. JAMA. 2010; 304: 657-63.

31. Hartle J.E., Tang X., Kirchner H.L., Bucaloiu I.D. et al. Bisphosphonate therapy, death, and cardiovascular events among female patients with CKD: a retrospective cohort study. Am. J. Kidney Dis. 2012; 59: 636-44.

32. Kanis J.A., Johansson H., Oden A., McCloskey E.V. A meta-analysis of the effect of strontium ranelate on the risk of vertebral and non-vertebral fracture in postmenopausal osteoporosis and the interaction with FRAX®. Osteoporos. Int. 2011; 22: 2347-55.

33. Reginster J.Y., Kaufman J.M., Goemaere S. et al. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos. Int. 2012; 23: 1115-22.

34. Stevenson M., Davis S., Lloyd-Jones M., Beverley C. The clinical effectiveness and cost-effectiveness of strontium ranelate for the prevention of osteoporotic fragility fractures in postmenopausal women. Health Technol. Assess. 2007;11: 1-134.

35. Lecart M.P., Reginster J.Y. Current options for the management of postmenopausal osteoporosis. Expert Opin. Pharmacother. 2011; 12(16): 2533-52.

36. Cummings S.R., San Martin J., McClung M.R. et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N. Engl. J. Med. 2009; 361: 756-65.

37. Middleton E.T., Steel S.A., Aye M., Doherty S.M. The effect of prior bisphosphonate therapy on the subsequent BMD and bone turnover response to strontium ranelate. J. Bone Miner. Res. 2010; 25: 455-62.

38. Ershova O.B., Belova K.Yu., Nazarova A.V. Active metabolites of vitamin D: use in osteoporosis. Osteoporos i osteopatii. 2009; 1: 27-32. (in Russian)

39. O’Donnell S., Moher D., Thomas K., Hanley D.A., Cranney A. Systematic review of the benefits and harms of calcitriol and alfacalcidol for fractures and falls. J. Bone Miner. Metab. 2008; 26(6): 531-42.

40. Ringe J.D., Farahmand P., Schacht E. Alfacalcidol in men with osteoporosis: a prospective, observational, 2-year trial on 214 patients. Rheumatol. Int. 2013; 3: 637-43.

41. Belaya Zh.E., Rozhinskaya L.Ya. Bisphosphonates in the therapy of postmenopausal osteoporosis. Doctor.Ru. 2010; 7: 29-38. (in Russian)

42. Ogata M., Iwasaki N., Ide R., Takizawa M. et al. The relationship between metabolic syndrome and osteoporosis: a Review. Nutrients. 2016; 8: E347.

43. Ringe J.D., Farahmand P., Schacht E., Rozehnal A. Superiority of a combined treatment of Alendronate and Alfacalcidol compared to the combination of Alendronate and plain vitamin d or Aalfacalcidol alone in established post-menopausal or male osteoporosis (AAC-Trial). Rheumatol. Int. 2007;27: 425-34.

44. Orimo H., Nakamura T., Fukunaga M., Ohta H. et al. A-TOP (Adequate Treatment of Osteoporosis) research group. Effects of alendronate plus alfacalcidol in osteo- porosis patients with a high risk of fracture: the Japanese Osteoporosis Intervention Trial (JOINT) - 02. Curr. Med. Res. Opin. 2011; 27: 1273-84.

45. Nakamura Y., Suzuki T., Kamimura M., Ikegami S., Uchiyama S., Kato H. Alfacalcidol increases the therapeutic efficacy of ibandronate on bone mineral density in Japanese women with primary osteoporosis. Tohoku J. Exp. Med. 2017; 241: 319-26.

46. Orimo H. Clinical application of 1•(OH)D3 in Japan. Aktuel Rheumatol. 1994; 19(Suppl.): 27-30.

47. Richy F., Dukas L., Schacht E. Differential effects of D-hormone analogs and native vitamin D on the risk of falls: a comparative meta-analysis. Calcif. Tissue Int. 2008; 82(2): 102-7.

48. Ringe D., Dorst A., Faber H., Schlacht E. et al. Superiority of alfacalcidol over plain vitamin D in the treatment of glucocorticoid-induced osteoporosis. Rheumatol. Int. 2004; 24(2): 63-70.

Received 21.04.2017

Accepted 28.04.2017

About the Authors

Irina Vsevolodovna Kuznetsova, MD, Professor of the 1st Department of Obstetrics and Gynecology, Faculty of Physiology, I.M. Sechenov First Moscow State Medical University. 119992, Russia, Moscow, Malaya Trubetskaya str. 8 bld. 2

For citations: Kuznetsova I.V. Active vitamin D metabolites in the therapy
of menopausal osteoporosis. Akusherstvo i Ginekologiya/
Obstetrics and Gynecology. 2017; (6): 26-34. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.26-34

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.