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Use of alfacalcidol or eldecalcitol given as the same time with denosumab therapy is suitable keeping in mind the therapeutic effect of denosumab, prevention of hypocalcemia, and renal function.
The
activated vitamin D preparations are therapeutically effective as concomitant
medications with denosumab therapy for the prevention of hypocalcemia, and its
influence on renal function, as depicted in 'The Journal of Obstetrics and
Gynecology Research'.
Denosumab
helps prevent osteoporosis as it potently inhibits bone resorption, but it
requires oral therapy using calcium and vitamin D preparations to avert from
the side effects of hypocalcemia. Typically, a combination drug containing
calcium, natural vitamin D, and magnesium is used. If activated vitamin D has
been used prior to the initiation of denosumab therapy, then the continued use
of activated vitamin D was not unfamiliar. Saito S et al. focused on
investigating the combination vitamin D preparation, alfacalcidol, and
eldecalcitol on the therapeutic effect on denosumab therapy, a preventive effect
on hypocalcemia, and effect on the renal function to reveal the optimal choice
of concomitant medication.
Total of 39 patients was considered for this retrospective and single-centre study. A comparison was made between these patients who used denosumab (60 mg dose) for at least 12 months between November 2013 - October 2015, those who used combination medication concomitantly as the standard treatment, those who used alfacalcidol and eldecalcitol concomitantly.
It was found that the denosumab therapy markedly increased lumbar spine and femoral neck bone densities at 12 months in the three groups. No distinct difference in the rate of increase in bone density was observed. There were marked decreases in bone metabolism markers in the three groups, although it had no intergroup differences. Over 12 months, there were no hypercalcemia, hypocalcemia, or apparent renal dysfunction.
The Journal of Obstetrics and Gynecology Research
Activated vitamin D3 formulations can be safely used as concomitant medication for prevention of denosumab-induced hypocalcemia in women with postmenopausal osteoporosis
Saito S et al.
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