Vitamin D status in patients treated with intravenous ibandronate – a cohort study
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 11
Abstract
Osteoporosis is a social disease, which in individual cases leads to disability and generates high costs of the treatment of its complications. Its treatment before the fractures occur should be conducted in as great as possible group of patients. Therefore we need unambiguous standards for therapeutic action. We posses wide options of antiresorptic agents and bisphosphonates are the most important among them. However, for successful treatment of osteoporosis, proper supplementation of calcium and vitamin D is necessary. Polish guidelines recommend using of 800-1000 units in Autumn and Winter; in people older than 65 vitamin D3 should be administered all over the year. Patients with osteoporosis may need greater doses, also given twelve month a year. In Poland OTC preparations of calcium + vitamin D contain usually 200-400 unit of cholecalciferol, so provide the lowest recommended dose after taken at least two tablets per day for healthy adults. However, it may be an insufficient dose for people with osteoporosis, especially if they have additionally disorders of gastrointestinal tract and taking antiulcer drugs.<br>In 100 consecutive women with upper gastrointestinal tract disorders referred to our clinic for intravenous ibandronate treatment, which were at least six month before admission treated with calcium and vitamin D, we measured serum 25OHD3 concentrations. We found that only in 8 of them the concentrations were normal (i.e. > 30 ng/ml), so we qualified them to undertake the antiresorptic treatment. The average concentration of 25OHD3 in our group was 17.91 ng/ml (± 4.04), and in most cases (69%) was lower than 20 ng/ml. In ten women concentration was lower than 10 ng/ml and evident signs of muscle weakness were present. These women had the lowest BMD in the group and secondary hyperparathyroidism. Most of examined women were treated with 200-800 units of vitamin D per Day. Only 10 patients used 1000-2000 units daily – – 8 of them had serum 25OHD3 in normal ranges.<br>The results of this simple study shows that doses used in Poland, derived mainly from compound preparations are insufficient for proper supplementation of vitamin D.
Authors and Affiliations
Lucyna Papierska, Waldemar Misiorowski, Michał Rabijewski, Piotr Dudek, Małgorzata Gietka-Czernel
Keywords
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