Original Article
Treatment of Postmenopausal Osteoporosis with Calcitriol or Calcium
N Engl J Med 1992; 326:357-362February 6, 1992
- Abstract
Background and Methods.
Osteoporosis is a common problem whose management is controversial. To evaluate the efficacy and safety of calcitriol (1,25-dihydroxyvitamin D3) in the treatment of postmenopausal osteoporosis, we conducted a three-year prospective, multicenter, single-blind study in 622 women who had one or more vertebral compression fractures. The women were randomly assigned to receive treatment with calcitriol (0.25 μg twice a day) or supplemental calcium (1 g of elemental calcium daily) for three years. New vertebral fractures were detected by means of lateral roentgenography of the spine each year, and calcium absorption was measured in 392 of the women.
Results.
The women who received calcitriol had a significant reduction in the rate of new vertebral fractures during the second and third years of treatment, as compared with the women who received calcium (second year, 9.3 vs. 25.0 fractures per 100 patient-years; third year, 9.9 vs. 31.5 fractures per 100 patient-years; P<0.001). This effect was evident only in women who had had five or fewer vertebral fractures at base line (second year, 5.2 vs. 25.3 fractures per 100 patient-years; third year, 4.2 vs. 31.0 fractures per 100 patient-years; P<0.0001). The groups also differed significantly in the number of peripheral fractures; 11 such fractures occurred in 11 women in the calcitriol group, whereas 24 occurred in 22 women in the calcium group (P<0.05). There was no significant difference between the groups in the incidence of side effects requiring withdrawal of treatment (8.6 percent in the calcitriol group vs. 6.5 percent in the calcium group).
Conclusions.
Continuous treatment of postmenopausal osteoporosis with calcitriol for three years is safe and significantly reduces the rate of new vertebral fractures in women with this disorder. (N Engl J Med 1992; 326:357–62.)
Media in This Article
Figure 1
Proportion of Women in the Calcitriol and Calcium Groups Who Did Not Have New Vertebral Fractures during the Three Years of Study.Table 1
Clinical and Biochemical Characteristics of the Calcitriol and Calcium Groups at Base Line.*Article Activity
- Article
POSTMENOPAUSAL osteoporosis is a common disorder that results in substantial morbidity and mortality.1 Many agents have been used to treat it, including estrogen, bisphosphonates, anabolic steroids, calcium, calcitonin, and sodium fluoride, of which the most widely used are estrogen and calcium. Another agent, calcitriol (1,25-dihydroxyvitamin D3), has attracted considerable interest during the past decade because of its ability to increase gastrointestinal absorption of calcium and also to stimulate osteoblastic and osteoclastic activity in the skeleton.2 3 4 The decrease in calcium intake and the fractional intestinal absorption of calcium with increasing age are thought to be important factors in the pathogenesis of osteoporosis. Calcitriol is the principal determinant of intestinal calcium absorption, but whether calcitriol deficiency is a major cause of osteoporosis is uncertain, since serum calcitriol concentrations have been found to be both low and normal among women with postmenopausal osteoporosis.5 6 7 8 9 10 11 12 13 14 15 16 17 18
The results of major clinical trials of calcitriol therapy in women with osteoporosis are conflicting.4 , 6 , 13 , 19 20 21 22 23 24 25 26 27 For example, Aloia et al.25 found that calcitriol treatment reduced bone loss in women with postmenopausal osteoporosis by increasing calcium absorption and reducing bone resorption, whereas Ott and Chesnut26 found calcitriol to be ineffective in the treatment of established osteoporosis. Gallagher and Goldgar27 recently demonstrated that treating postmenopausal osteoporosis with calcitriol for two years was associated with an increase in spinal bone density and total body calcium, as compared with placebo administration. Several factors differed among these studies, including the criteria for enrolling patients, the dosage of calcitriol, the number of patients studied, and the criteria used to evaluate efficacy. None of the studies were large enough to evaluate the effect of calcitriol on the incidence of fractures. Therefore, we undertook a prospective, randomized, three-year trial to determine the effect of calcitriol on the rate of new vertebral fractures and the safety of the drug in women with postmenopausal osteoporosis in comparison with calcium supplementation. The data for the first year of follow-up in this trial have been reported previously.28
Methods
Patients
The 622 patients enrolled in the study were fully ambulatory postmenopausal women 50 to 79 years old. All had osteoporosis but no evidence of any disease associated with osteoporosis or other major medical problems and no history of using any drug known to cause or ameliorate osteoporosis; specifically, none of the women were taking estrogen. The diagnosis of osteoporosis was based on the presence of one or more nontraumatic vertebral compression fractures as seen on a lateral spinal roentgenogram; a fracture was defined as a reduction in the height of the anterior border of a vertebral body by 20 percent or more, as compared with the height of the posterior border. The patients were recruited from among 805 white women who had been screened because they had a history of previous fractures of the wrist or hip, loss of height, dowager's hump, or chronic back pain, diagnosed by 123 primary care physicians in 1986 and 1987. None of the women had previously participated in clinical trials of other drugs, none were enrolled because they had not responded to standard treatment regimens, and all had normal laboratory values (see below) at base line.
The study was approved by the Ethics Committee of the Otago Area Health Board, and the patients gave written informed consent.
Experimental Design
Each of the 123 participating primary care physicians had separate randomization codes that were used to assign the women to either calcitriol therapy or calcium supplementation. Both the women and the physicians were aware of the treatment assignment after randomization. The 314 women in the calcitriol-therapy group received 0.25 μg of calcitriol twice a day, and the 308 women in the calcium-supplementation group received 1 g of elemental calcium daily, in the form of 5.2 g of calcium gluconate twice a day. Pills were not formally counted to assess compliance.
The women were given no specific instructions regarding dietary calcium intake, which was assessed at base line according to the National Diet Survey in the report to the National Heart Foundation of New Zealand29 and at 24 months according to a dietary diary kept for 7 days. They were instructed to take no calcium supplements in tablet form other than the supplement supplied for the study. The women were given no advice about their ordinary physical activity, and no program of exercise was undertaken.
Laboratory Studies and Safety Assessment
Liver-function tests, measurements of serum calcium (adjusted for the serum albumin concentration), phosphate and creatinine concentrations, complete blood counts, determinations of the erythrocyte sedimentation rate, and microscopical examinations of sediment from midstream urine specimens were performed before treatment and yearly thereafter. Serum calcium and creatinine concentrations were also measured after 1,3,6, 9, 18, and 30 months of treatment. If hypercalcemia developed (serum calcium level >2.6 mmol per liter) or renal function deteriorated (serum creatinine level > 120 μmol per liter), the dose of trial medication was halved; if laboratory values did not return to normal within four weeks, the medication was stopped. After 24 months, a random subsample of 200 women (100 from each group) collected a 24-hour urine sample for measurement of creatinine clearance and urinary calcium excretion. (No dietary advice was given, and the patients continued taking their medication at this time.) Renal ultrasonography and tomography were also performed at 24 months in 120 women (60 randomly selected from each group) to determine the incidence of nephrocalcinosis.
At 30 months calcium absorption was determined indirectly in 392 women by the measurement of 24-hour urinary calcium excretion before and after they received 1 g of elemental calcium. Before the measurement, calcitriol or calcium therapy was discontinued for a minimum of two weeks and a maximum of three weeks, during which the women were to follow a diet with a calcium content of 800 mg per day. Treatment was then resumed. Women in whom the rate of 24-hour urinary calcium excretion measured at this time was less than or equal to the rate measured previously were considered to have calcium malabsorption.
Assessment of Fractures
Treatment efficacy was assessed by determining the rate at which new fractures appeared. For this assessment, a fracture was defined as a decrease of 15 percent or more during any one year in the anterior or posterior height of the body of each vertebra from T4 through L4. Thus, a 15 percent reduction in one year and a 15 percent reduction at the same site in another year were counted as two fractures. Roentgenograms of the thoracic and lumbar spine were obtained each year, with the lens at a constant focal length. A second lateral roentgenogram was obtained within four weeks of the yearly roentgenogram in 10 percent of the women randomly selected each year, to assess the degree of reproducibility. The heights of the anterior and posterior margins of each vertebral body were measured to the nearest 0.1 mm; all spinal measurements were made with an electronic caliper by a single technician who did not know the treatment assignment. A random sample of 10 percent of all films was remeasured by the technician to determine the reproducibility of the measurement technique. The 95 percent confidence interval for the error of measurement of the height of vertebral bodies was —7.7 to 6.7 percent. The comparable interval for the second measurement, made within the following month, was —9.2 to 8.3 percent. Peripheral fractures were detected by questioning the patient, but were counted only if they had been documented radiologically.
Statistical Analysis
The goals of the study were to assess the effect of calcitriol therapy on the incidence of vertebral fractures and to examine the safety profile of calcitriol at the study dosage, including the incidence of hypercalcemia. To detect a statistically significant difference (50 percent, with a two-tailed P value <0.05) in fracture rates between the calcitriol and calcium groups with a power of 90 percent, we estimated that a sample of 554 women would be required.
The two treatment groups were compared for the relative risk of fracture by two-tailed standard-error tests, on the assumption that the number of fractures per patient would follow a Poisson distribution. The proportion of women in each group who had any fractures was compared by standard-error tests. In all analyses, the results reflected all available data for the 622 women who entered the trial, whether or not they completed the three-year study. A formal intention-to-treat analysis was not undertaken because it was not permissible (ethically) to require a patient to be further involved in the study after she had withdrawn.
Chi-square analysis was used to examine differences between the treatment groups in the rates of withdrawal. Biochemical variables were analyzed with two-tailed standard-error tests.
Results
Clinical Findings
The major clinical and biochemical characteristics of the 622 women at base line are shown in Table 1Table 1
Clinical and Biochemical Characteristics of the Calcitriol and Calcium Groups at Base Line.*. There were no significant differences between the two treatment groups. Of the 622 women enrolled, 515 completed one year of treatment, 476 completed two years, and 432 completed three years. The number of women for whom treatment was discontinued and the reasons for discontinuation are listed in Table 2Table 2
Reasons for Premature Withdrawal from the Study..Safety of Treatment
For the purposes of this analysis, a side effect was defined as a sign or symptom sufficiently severe to warrant withdrawal from the study. Twenty-seven of the women who received calcitriol and 20 of those who received calcium had side effects during the three years (8.6 percent vs. 6.5 percent, P>0.05). The most common reason for withdrawal (55 percent of withdrawals) was gastrointestinal symptoms, mostly nausea. Two women receiving calcitriol had persistently elevated serum calcium concentrations (>2.6 mmol per liter) that necessitated their withdrawal from the study. No woman had renal colic or passed a stone in her urine. Among the 120 women who underwent renal ultrasonography and tomography after two years of treatment, 1 woman in the calcium group had nephrocalcinosis.
In 23 women, other medical conditions developed that necessitated their withdrawal from the study; 14 other women required therapy with other drugs and were withdrawn. Nine women died; their deaths were not found to be related to either of the study treatments.
Biochemical Measurements
In both treatment groups combined, the mean serum calcium concentration increased by 0.04 mmol per liter (P<0.001) and the mean serum creatinine concentration by 5 μmol per liter (P<0.001), but the concentrations were within the normal range at the end of treatment; there were no significant differences between the two groups when they had increased values. Among the 100 women from each group in whom creatinine clearance and urinary calcium excretion were measured after two years, those receiving supplemental calcium had a mean creatinine clearance of 1.1 ml per second, whereas those receiving calcitriol had a mean rate of 1.2 ml per second (P>0.05). In contrast, the groups differed significantly in 24-hour urinary calcium excretion, with a mean of 5.7 mmol per day in the calcitriol group and 4.1 mmol per day in the calcium group (P<0.001). The rate of urinary calcium excretion was more than 7.5 mmol per day in 16 percent of the calcitriol group and 7 percent of the calcium group. None of the women with increased calcium excretion had elevated serum calcium concentrations at any time.
Calcium-absorption tests, performed after 30 months of treatment, were completed in 392 women (201 in the calcitriol group and 191 in the calcium group). The proportion considered to have calcium malabsorption was 21 percent in the calcitriol group and 29 percent in the calcium group (P>0.05).
Vertebral Fractures
Table 3Table 3
New Vertebral Fractures According to Study Year. shows the rates of new vertebral fractures per patient-year of follow-up and the number of women with new vertebral fractures in both the calcitriol and calcium groups. After one year of treatment, the fracture rate per 100 patient-years was 8.8 in the calcitriol group and 10.3 in the calcium group (P>0.05). After the second year of treatment, the rate of new vertebral fractures was significantly reduced in the calcitriol group as compared with the calcium group (9.3 vs. 25.0 per 100 patient-years; P<0.001). Also, the number of women who had new fractures during the second year of treatment was significantly lower in the calcitriol group than in the calcium group (14 vs. 30, P<0.01). The difference in the fracture rates between the groups increased after the third year (calcitriol vs. calcium, 9.9 vs. 31.5 per 100 patient-years; P<0.001). Also, significantly fewer women in the calcitriol group than in the calcium group had new fractures during the third year (12 vs. 44, P<0.001). Figure 1Figure 1Proportion of Women in the Calcitriol and Calcium Groups Who Did Not Have New Vertebral Fractures during the Three Years of Study. shows the proportion of women in each group who had no fractures during the treatment period.The rates of new vertebral fractures per 100 patient-years, stratified retrospectively according to the number of vertebral fractures at base line, are shown in Table 4Table 4
New Vertebral Fractures According to Study Year and Number of Fractures at Base Line.. The women were classified as having severe osteoporosis (>5 fractures) or mild-to-moderate osteoporosis (≤5 fractures) at base line. There were no statistically significant differences between the two treatment groups when stratified according to the number of vertebral fractures during the first year of treatment. However, after the second year of treatment the new fracture rate (per 100 patient-years) for women who had five or fewer vertebral fractures at base line was 5.2 in the calcitriol group and 25.3 in the calcium group (P<0.0001); the numbers of women who had new fractures also differed significantly (7 vs. 24, P<0.01). This difference continued in the third year; the calcitriol group had a significant reduction in both the new-fracture rate (4.2 vs. 31.0 per 100 patient-years, P<0.0001) and the number of women with new fractures (6 vs. 30, P<0.001). There were no differences at any time in the rate of new fractures among the women who had more than five fractures at base line.Table 5Table 5
New Vertebral Fractures According to Study Year and Calcium-Absorption Status. shows the rates of new vertebral fractures (per 100 patient-years) stratified according to the patient's ability to absorb calcium. After one year of treatment, there were no statistically significant differences between the two treatment groups when patients were stratified according to their calcium-absorption status. During the second year of therapy, the rate of new fractures among the women with normal absorption was 11.9 in the calcitriol group and 25.2 in the calcium group (P<0.01); the rate among the women with malabsorption was 7.1 in the calcitriol group and 28.8 in the calcium group (P<0.05). There were no significant differences in the number of women with new fractures in either of these subgroups. In the third year, the differences between the calcium-absorption subgroups in the rate of new vertebral fractures continued to be significant (11.9 vs. 39.2 per 100 patient-years [P<0.0001] in the women with normal absorption and 4.7 vs. 28.6 [P<0.01] in those with malabsorption). In each subgroup, significantly fewer women receiving calcitriol had new fractures than did women receiving calcium (31 vs. 10 [P<0.0001] for women with normal calcium absorption and 13 vs. 2 [P<0.05] for women with calcium malabsorption). Calcium-absorption status had no effect on the rate of fractures in the treatment groups.Peripheral Fractures
There was a significant difference between the treatment groups in the number of peripheral fractures during the three years of the study. There were 11 peripheral fractures in 11 women in the calcitriol group and 24 in 22 women in the calcium group (P<0.05). These fractures occurred at various sites, including the hip (7 fractures), the wrist (13), the forearm (8), and other sites (7).
Discussion
Treatment with calcitriol for three years resulted in a threefold reduction in the rate of new vertebral fractures in women with postmenopausal osteoporosis, as compared with treatment with calcium during the same period. The effect of calcitriol was evident only after two years and only in women who had mild-tomoderate osteoporosis (i.e., those with five or fewer fractures at base line). Calcitriol was effective both in women with normal calcium absorption and in those with calcium malabsorption, especially the latter. Calcitriol treatment was not accompanied by hypercalcemia of any severity.
The use of calcitriol in the treatment of osteoporosis has been controversial. Demonstration of a benefit has often required doses that cause hypercalcemia25; studies using lower doses have shown no benefit.26 Furthermore, the studies have used various end points, including biochemical indexes,22 bone mass,25 26 27 and the incidence of fractures,25 , 30 but those using fracture rates have involved too few patients to demonstrate any effect conclusively. Our study was designed to be sufficiently large so that the incidences of new vertebral fractures during treatment with calcitriol and with calcium could be compared with acceptable statistical power.
We did not study the mechanism of action of calcitriol in the women with osteoporosis. Calcitriol is the most important regulator of intestinal calcium absorption. It also acts directly on osteoblasts to stimulate the synthesis of osteocalcin, and it acts on osteoclasts to stimulate resorption of bone.31 Our finding that there was no difference in the rate of new fractures between calcitriol recipients with normal calcium absorption and those with calcium malabsorption suggests that calcitriol improves calcium absorption in the gastrointestinal system and at other sites controlling bone metabolism.
It is important to note that nearly one third of the women did not complete the study; the proportion was 26 percent after exclusion of the women who withdrew before starting therapy. If follow-up is expressed in terms of patient-years, we achieved 76 percent of the follow-up possible if all 622 women had completed the study or 81 percent of the follow-up possible if the 39 women who did not begin treatment were excluded. We doubt that the rate of premature withdrawal biased our results, since it was similar in both groups. The annual rate of premature withdrawal compared favorably with that in another large clinical trial in elderly women with osteoporosis.32
The potential of calcitriol to induce hypercalcemia27 and possibly renal-stone formation has limited the use of this agent to treat postmenopausal osteoporosis. After receiving the dose used in this study (0.25 μg twice a day), only two women (0.4 percent) had hypercalcemia and none of the women examined for nephrocalcinosis had that complication. Indeed, there is little evidence that the use of calcitriol has ever led to a kidney stone, despite the large number of patients treated with this drug31; in another study,27 administering calcitriol in a mean dose of 0.62 μg per day for two years had no adverse effects on renal function. Calcitriol given orally in a dose of 0.25 μg twice a day to postmenopausal women with an average dietary calcium intake of 800 mg, therefore, has limited potential to induce hypercalcemia. Clearly, however, serum calcium concentrations should be monitored in patients receiving calcitriol therapy.
In conclusion, three years of calcitriol therapy in women with postmenopausal osteoporosis significantly reduced the incidence of new vertebral fractures as compared with calcium gluconate supplementation. When administered in a dose of 0.25 μg twice a day, calcitriol had no important side effects. These results suggest that calcitriol is an important therapeutic option in the treatment of women with postmenopausal osteoporosis.
Supported by Roche Products (N.Z.) Ltd.
Source Information
From the Department of General Practice, Medical School (M.W.T., J.T., S.D.), and the Department of Preventive and Social Medicine (G.F.S.S.), University of Otago, Dunedin, New Zealand. Address reprint requests to Dr. Tilyard at the RNZCGP Research Unit, Department of General Practice, University of Otago, P.O. Box 913, Dunedin, New Zealand.
- References
References
1
Riggs
Full Text | Web of Science | Medline2
De Luca
Medline3
Kumar
CrossRef | Web of Science | Medline4
Chesney
Web of Science | Medline5
Aloia
CrossRef | Web of Science | Medline6
Caniggia
Web of Science | Medline7
Tsai 8
Gallagher
CrossRef | Web of Science | Medline9
Gallagher
CrossRef | Web of Science | Medline10
S0renson
CrossRef | Web of Science | Medline11
Zerwekh
CrossRef | Web of Science | Medline12
Riggs
CrossRef | Web of Science | Medline13
Lore
CrossRef | Web of Science | Medline14
Lund
CrossRef | Web of Science | Medline15
Lawoyin
CrossRef | Web of Science | Medline16
Crilly
CrossRef | Web of Science | Medline17
Slovik
Full Text | Web of Science | Medline18
Riggs
Web of Science | Medline19
Jensen
CrossRef | Web of Science | Medline20
Tjellesen
CrossRef | Web of Science | Medline21
Recker 22
Need
Medline23
Jensen
Web of Science | Medline24
Riggs
CrossRef | Web of Science | Medline25
Aloia
CrossRef | Web of Science | Medline26
Ott
Web of Science | Medline27
Gallagher
Web of Science | Medline28
Tilyard
CrossRef | Web of Science | Medline29
Birkbeck JA. New Zealanders and their diet: a report to the National Heart Foundation of New Zealand on the National Diet Survey. Dunedin, New Zealand: University of Otago, 1977.
30
Gallagher
Web of Science | Medline31
DeLuca
CrossRef | Web of Science | Medline32
Riggs
Full Text | Web of Science | Medline
- Citing Articles (159)
Citing Articles
1
Tatsuo Suda, Fumiaki Takahashi, Naoyuki Takahashi. (2011) Bone Effects of Vitamin D - Discrepancies between in vivo and in vitro studies -. Archives of Biochemistry and Biophysics
CrossRef2
Toshio Matsumoto, Masako Ito, Yasufumi Hayashi, Takako Hirota, Yusuke Tanigawara, Teruki Sone, Masao Fukunaga, Masataka Shiraki, Toshitaka Nakamura. (2011) A new active vitamin D3 analog, eldecalcitol, prevents the risk of osteoporotic fractures — A randomized, active comparator, double-blind study. Bone 49:4, 605-612
CrossRef3
Goran Bjelakovic, Lise Lotte Gluud, Dimitrinka Nikolova, Kate Whitfield, Jørn Wetterslev, Rosa G Simonetti, Marija Bjelakovic, Christian Gluud, Goran Bjelakovic. 2011. Vitamin D supplementation for prevention of mortality in adults. .
CrossRef4
Yoshihiro Sato, Jun Iwamoto, Yoshiaki Honda. (2011) Vitamin D Deficiency-Induced Vertebral Fractures May Cause Stooped Posture in Parkinson Disease. American Journal of Physical Medicine & Rehabilitation 90:4, 281-286
CrossRef5
Hector F DeLuca, Wendy Bedale, Neil Binkley, J Chris Gallagher, Michael Bolognese, Munro Peacock, John Aloia, Margaret Clagett-Dame, Lori Plum. (2011) The vitamin D analogue 2MD increases bone turnover but not BMD in postmenopausal women with osteopenia: Results of a 1-year phase 2 double-blind, placebo-controlled, randomized clinical trial. Journal of Bone and Mineral Research 26:3, 538-545
CrossRef6
Peter R. Ebeling, John A. Eisman. 2011. Vitamin D and Osteoporosis. , 1129-1144.
CrossRef7
Lori A. Plum, Hector F. DeLuca. (2010) Vitamin D, disease and therapeutic opportunities. Nature Reviews Drug Discovery 9:12, 941-955
CrossRef8
E. Schacht, Johann D. Ringe. (2010) Alfacalcidol improves muscle power, muscle function and balance in elderly patients with reduced bone mass. Rheumatology International
CrossRef9
Jerald E. Dumas, Thomas Davis, Ginger E. Holt, Toshitaka Yoshii, Daniel S. Perrien, Jeffry S. Nyman, Todd Boyce, Scott A. Guelcher. (2010) Synthesis, characterization, and remodeling of weight-bearing allograft bone/polyurethane composites in the rabbit. Acta Biomaterialia 6:7, 2394-2406
CrossRef10
Glenville Jones. (2010) Vitamin D Analogs. Endocrinology & Metabolism Clinics of North America 39:2, 447-472
CrossRef11
J. D. Ringe, E. Schacht. (2009) Potential of alfacalcidol for reducing increased risk of falls and fractures. Rheumatology International 29:10, 1177-1185
CrossRef12
, Hans Peter Dimai, Peter Pietschmann, Heinrich Resch, Elisabeth Preisinger, Astrid Fahrleitner-Pammer, Harald Dobnig, Klaus Klaushofer. (2009) Österreichischer Leitfaden zur medikamentösen Therapie der postmenopausalen Osteoporose – Update 2009. Wiener Medizinische Wochenschrift 159:S122, 1-34
CrossRef13
Alison Avenell, William J Gillespie, Lesley D Gillespie, Dianne O'Connell, Alison Avenell. 2009. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. .
CrossRef14
Wei-bo Xia, Zhong-lan Zhang, Hong-fu Wang, Xun-wu Meng, Ying Zhang, Guo-ying Zhu, Xiao-ping Xing, Jian-li Liu, Li-hua Wang, Yan Jiang, Shi-fang Weng, Tao Xu, Ying-ying Hu, Wei Yu, Jun-ping Tian. (2009) The efficacy and safety of calcitriol and/or Caltrate D in elderly Chinese women with low bone mass. Acta Pharmacologica Sinica 30:3, 372-378
CrossRef15
Jin Young Kim, Eun Su Moon, Hwan Mo Lee, Seong Hwan Moon, Jin Oh Park, Jee Ho Hyung, Hak Sun Kim. (2009) Prevention of New Vertebral Fractures after Treatment with Risedronate, Alendronate or Calcium Carbonate in Patients with Osteoporotic Compression Fracture Treated with Cement Augmentation. The Journal of the Korean Orthopaedic Association 44:4, 436
CrossRef16
Alex J. Brown, Eduardo Slatopolsky. (2008) Vitamin D analogs: Therapeutic applications and mechanisms for selectivity. Molecular Aspects of Medicine 29:6, 433-452
CrossRef17
C. J. Andresen, M. Moalli, C. H. Turner, E. Berryman, R. Pero, C. M. Bagi. (2008) Bone Parameters are Improved with Intermittent Dosing of Vitamin D3 and Calcitonin. Calcified Tissue International 83:6, 393-403
CrossRef18
Hideaki Nagaoka, Yoshiyuki Mochida, Phimon Atsawasuwan, Masaru Kaku, Toshirou Kondoh, Mitsuo Yamauchi. (2008) 1,25(OH)2D3 regulates collagen quality in an osteoblastic cell culture system. Biochemical and Biophysical Research Communications 377:2, 674-678
CrossRef19
Yan Li, Carl-Magnus Bäckesjö, Lars-Arne Haldosén, Urban Lindgren. (2008) Species difference exists in the effects of 1α,25(OH)2D3 and its analogue 2-methylene-19-nor-(20S)-1,25-dihydroxyvitamin D3 (2MD) on osteoblastic cells. The Journal of Steroid Biochemistry and Molecular Biology 112:1-3, 110-116
CrossRef20
Brett A. Freedman, Benjamin K. Potter, Leon J. Nesti, Jeffrey R. Giuliani, Chadwick Hampton, Timothy R. Kuklo. (2008) Osteoporosis and vertebral compression fractures—continued missed opportunities. The Spine Journal 8:5, 756-762
CrossRef21
, J. A. Kanis, N. Burlet, C. Cooper, P. D. Delmas, J.-Y. Reginster, F. Borgstrom, R. Rizzoli. (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International 19:4, 399-428
CrossRef22
Erich Schacht. (2008) Reduction of falls and osteoporotic fractures: Plain vitamin D or D-hormone analogs?. Geriatrics & Gerontology International 8, S16-S25
CrossRef23
Anthony Norman, Helen Henry. 2007. Vitamin D. .
CrossRef24
Kent Wehmeier. 2007. Nutrition and Fracture Risk. , 511-536.
CrossRef25
S. von Rosenberg, U. Wehr, H. Bachmann. (2007) Effect of vitamin D-containing plant extracts on osteoporotic bone. The Journal of Steroid Biochemistry and Molecular Biology 103:3-5, 596-600
CrossRef26
Lee S. Simon. (2007) Osteoporosis. Rheumatic Disease Clinics of North America 33:1, 149-176
CrossRef27
Naohiko Okamoto, Seiji Aruga, Kyoichi Tomita, Takumi Takeuchi, Tadaichi Kitamura. (2007) Chronic acid ingestion promotes renal stone formation in rats treated with vitamin D3. International Journal of Urology 14:1, 60-66
CrossRef28
Bronwyn A Crawford, Eternity D Labio, Simone I Strasser, Geoffrey W McCaughan. (2006) Vitamin D replacement for cirrhosis-related bone disease. Nature Clinical Practice Gastroenterology & Hepatology 3:12, 689-699
CrossRef29
Laura B Hansen. (2006) Osteoporosis update: effective prevention and treatment. Expert Review of Pharmacoeconomics & Outcomes Research 6:5, 525-540
CrossRef30
J. K. Dhesi, T. J. Allain, A. A. Mangoni, S. H. D. Jackson. (2006) The implications of a growing evidence base for drug use in elderly patients. Part 4. Vitamin D and bisphosphonates for fractures and osteoporosis. British Journal of Clinical Pharmacology 61:5, 521-528
CrossRef31
Lori A. Plum, Lorraine A. Fitzpatrick, Xiaohong Ma, Neil C. Binkley, Julia B. Zella, Margaret Clagett-Dame, Hector F. DeLuca. (2006) 2MD, a new anabolic agent for osteoporosis treatment. Osteoporosis International 17:5, 704-715
CrossRef32
K. F. Mauck, B. L. Clarke. (2006) Diagnosis, Screening, Prevention, and Treatment of Osteoporosis. Mayo Clinic Proceedings 81:5, 662-672
CrossRef33
E. M. C. LAU, P. SAMBROOK, E. SEEMAN, K. H. LEONG, P. C. LEUNG, P. DELMAS. (2006) Guidelines for diagnosing, prevention and treatment of osteoporosis in Asia. APLAR Journal of Rheumatology 9:1, 24-36
CrossRef34
R. Nuti, G. Bianchi, M.L. Brandi, R. Caudarella, E. D’Erasmo, C. Fiore, G.C. Isaia, G. Luisetto, M. Muratore, P. Oriente, S. Ortolani. (2006) Superiority of alfacalcidol compared to vitamin D plus calcium in lumbar bone mineral density in postmenopausal osteoporosis. Rheumatology International 26:5, 445-453
CrossRef35
Eric J MacLaughlin, Rebecca B Sleeper, Danny McNatty, Cynthia L Raehl. (2006) Management of age-related osteoporosis and prevention of associated fractures. Therapeutics and Clinical Risk Management 2:3, 281-295
CrossRef36
Jean-Yves Reginster, Nathalie Sarlet. (2006) The Treatment of Severe Postmenopausal Osteoporosis. Treatments in Endocrinology 5:1, 15-23
CrossRef37
Yoshihiro Sato, Yoshiaki Honda, Jun Iwamoto, Tomohiro Kanoko, Kei Satoh. (2005) Abnormal bone and calcium metabolism in immobilized Parkinson's disease patients. Movement Disorders 20:12, 1598-1603
CrossRef38
Ronald C. Hamdy, Charles H. Chesnut, Margery L. Gass, Michael F. Holick, Edward S. Leib, Michael E. Lewiecki, Michael Maricic, Nelson B. Watts. (2005) Review of Treatment Modalities for Postmenopausal Osteoporosis. Southern Medical Journal 98:10, 1000-1014
CrossRef39
Hua Zhu Ke, Hong Qi, D Todd Crawford, Hollis A Simmons, Gang Xu, Mei Li, Lori Plum, Margaret Clagett-Dame, Hector F DeLuca, David D Thompson, Thomas A Brown. (2005) A New Vitamin D Analog, 2MD, Restores Trabecular and Cortical Bone Mass and Strength in Ovariectomized Rats With Established Osteopenia. Journal of Bone and Mineral Research 20:10, 1742-1755
CrossRef40
Charles F. Hildebolt. (2005) Effect of Vitamin D and Calcium on Periodontitis. Journal of Periodontology 76:9, 1576-1587
CrossRef41
Alison Avenell, William J Gillespie, Lesley D Gillespie, Dianne O'Connell, Alison Avenell. 2005. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. .
CrossRef42
F. Richy, E. Schacht, O. Bruyere, O. Ethgen, M. Gourlay, J.-Y. Reginster. (2005) Vitamin D Analogs Versus Native Vitamin D in Preventing Bone Loss and Osteoporosis-Related Fractures: A Comparative Meta-analysis. Calcified Tissue International 76:3, 176-186
CrossRef43
John Eisman, Sharon Clapham, Linda Kehoe. (2004) Osteoporosis Prevalence and Levels of Treatment in Primary Care: The Australian BoneCare Study. Journal of Bone and Mineral Research 19:12, 1969-1975
CrossRef44
Karin Weber, Cornelia Kaschig, Reinhold G. Erben. (2004) 1α-Hydroxyvitamin D2 and 1α-hydroxyvitamin D3 have anabolic effects on cortical bone, but induce intracortical remodeling at toxic doses in ovariectomized rats. Bone 35:3, 704-710
CrossRef45
Charles F. Hildebolt, Thomas K. Pilgram, Mary Dotson, Reina Armamento-Villareal, Jay Hauser, Sheldon Cohen, Roberto Civitelli. (2004) Estrogen and/or Calcium Plus Vitamin D Increase Mandibular Bone Mass. Journal of Periodontology 75:6, 811-816
CrossRef46
Christopher J. Olivera, Craig M. Bula, June E. Bishop, Luciano Adorini, Percy Manchand, Milan R. Uskokovic, Anthony W. Norman. (2004) Characterization of five 19-nor-analogs of 1α,25(OH)2-Vitamin D3 with 20-cyclopropyl-modified side-chains: implications for ligand binding and calcemic properties. The Journal of Steroid Biochemistry and Molecular Biology 89-90, 99-106
CrossRef47
Yoshihiro Sato, Masahide Kaji, Yoshiaki Honda, Norimasa Hayashida, Jun Iwamoto, Tomohiro Kanoko, Kei Satoh. (2004) Abnormal calcium homeostasis in disabled stroke patients with low 25-hydroxyvitamin D. Bone 34:4, 710-715
CrossRef48
R.M. Francis. (2004) Acute and long-term management of patients with vertebral fractures. QJM 97:2, 63-74
CrossRef49
B. E. Christopher Nordin, Peter D. O’Loughlin, Allan G. Need, Michael Horowitz, Howard A. Morris. (2004) Radiocalcium absorption is reduced in postmenopausal women with vertebral and most types of peripheral fractures. Osteoporosis International 15:1, 27-31
CrossRef50
D. Sudhaker Rao, Suhad Alqurashi. (2003) Management of vitamin D depletion in postmenopausal women. Current Osteoporosis Reports 1:3, 110-115
CrossRef51
P. K. K. Wong, D. G. Spencer, P. McElduff, N. Manolios, G. Larcos, G. B. Howe. (2003) Secondary screening for osteoporosis in patients admitted with minimal-trauma fracture to a major teaching hospital. Internal Medicine Journal 33:11, 505-510
CrossRef52
Sue A Brown, Clifford J Rosen. (2003) Osteoporosis. Medical Clinics of North America 87:5, 1039-1063
CrossRef53
M Ito, Y Azuma, H Takagi, T Kamimura, K Komoriya, T Ohta, H Kawaguchi. (2003) Preventive effects of sequential treatment with alendronate and 1α-hydroxyvitamin D3 on bone mass and strength in ovariectomized rats. Bone 33:1, 90-99
CrossRef54
Rick L. Smith. (2003) Calcium and Vitamin D Supplementation in Nursing Home Residents. Journal of the American Medical Directors Association 4:2, S24-S31
CrossRef55
Yusuke TSUKAMOTO, Tatsuhiko WATANABE, Tetsuo NAKAGAMI, Kaoru MORISHITA. (2003) Effect of Treatment with Oral Calcitriol on Calcium Metabolism and Fasting Serum 25(OH)- or 1,25(OH) 2-Vitamin D Level in Japanese Postmenopausal Women. Endocrine Journal 50:6, 681-687
CrossRef56
Rick L. Smith. (2003) Calcium and Vitamin D Supplementation in Nursing Home Residents. Journal of the American Medical Directors Association 4:Supplement, S24
CrossRef57
Reinhold G. Erben, Lis Mosekilde, Jesper S. Thomsen, Karin Weber, Kerstin Stahr, Alyson Leyshon, Susan Y. Smith, Roger Phipps. (2002) Prevention of Bone Loss in Ovariectomized Rats by Combined Treatment With Risedronate and 1α,25-Dihydroxyvitamin D3. Journal of Bone and Mineral Research 17:8, 1498-1511
CrossRef58
Kyoko Teramura, Shinji Fukushima, Kazutoshi Nozaki, Satoshi Kokubo, Koichiro Takahashi. (2002) Comparison of incadronate and alfacalcidol on increased bone turnover caused by ovariectomy in rats. European Journal of Pharmacology 449:1-2, 191-196
CrossRef59
Elizabeth Burgess, Mark S. Nanes. (2002) Osteoporosis in men: pathophysiology, evaluation, and therapy. Current Opinion in Rheumatology 14:4, 421-428
CrossRef60
Jun Iwamoto, Tsuyoshi Takeda, Shoichi Ichimura. (2002) Beneficial Effect of Etidronate on Bone Loss After Cessation of Exercise in Postmenopausal Osteoporotic Women. American Journal of Physical Medicine & Rehabilitation 81:6, 452-457
CrossRef61
Daphne J. Theodorou, Stavroula J. Theodorou, David J. Sartoris. (2002) Treatment of osteoporosis: Current status and recent advances. Comprehensive Therapy 28:2, 109-122
CrossRef62
Pierre D Delmas. (2002) Treatment of postmenopausal osteoporosis. The Lancet 359:9322, 2018-2026
CrossRef63
M.A Rodrı́guez-Martı́nez, E.C Garcı́a-Cohen. (2002) Role of Ca2+ and vitamin D in the prevention and treatment of osteoporosis. Pharmacology & Therapeutics 93:1, 37-49
CrossRef64
Masaya Ito, Yoshiaki Azuma, Hideko Takagi, Keiji Komoriya, Tomohiro Ohta, Hiroshi Kawaguchi. (2002) Curative Effect of Combined Treatment With Alendronate and 1α-Hydroxyvitamin D3 on Bone Loss by Ovariectomy in Aged Rats. The Japanese Journal of Pharmacology 89:3, 255-266
CrossRef65
Jean Wactawski-Wende. (2001) Periodontal Diseases and Osteoporosis: Association and Mechanisms. Annals of Periodontology 6:1, 197-208
CrossRef66
Rick L. Smith. (2001) Calcium and Vitamin D Supplementation in Nursing Home Residents. Journal of the American Medical Directors Association 2:6, 289-296
CrossRef67
Ming Chen, Song-Nan Chow. (2001) Additive effect of alfacalcidol on bone mineral density of the lumbar spine in Taiwanese postmenopausal women treated with hormone replacement therapy and calcium supplementation: a randomized 2-year study. Clinical Endocrinology 55:2, 253-258
CrossRef68
K Tsuji. (2001) Vitamin D3 enhances the expression of I-mfa, an inhibitor of the MyoD family, in osteoblasts. Biochimica et Biophysica Acta (BBA) - Molecular Cell Research 1539:1-2, 122-130
CrossRef69
Neer, Robert M.Arnaud, Claude D.Zanchetta, Jose R.Prince, RichardGaich, Gregory A.Reginster, Jean-YvesHodsman, Anthony B.Eriksen, Erik F.Ish-Shalom, SophiaGenant, Harry K.Wang, OuhongMellström, DanOefjord, Erik S.Marcinowska-Suchowierska, EwaSalmi, JormaMulder, HenkHalse, JohanSawicki, Andrzej Z.Mitlak, Bruce H.. (2001) Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis. New England Journal of Medicine 344:19, 1434-1441
Full Text70
Karin Weber, Michel Goldberg, Manfred Stangassinger, Reinhold G. Erben. (2001) 1α-Hydroxyvitamin D2 Is Less Toxic but Not Bone Selective Relative to 1α-Hydroxyvitamin D3 in Ovariectomized Rats. Journal of Bone and Mineral Research 16:4, 639-651
CrossRef71
Andreas Steinmeyer, Katica Schwarz, Martin Haberey, Gernot Langer, Herbert Wiesinger. (2001) Synthesis and biological activities of a new series of secosteroids: vitamin D phosphonate hybrids. Steroids 66:3-5, 257-266
CrossRef72
Ian G Finlay, Graham J Stewart, Javed Ahkter, David L Morris. (2001) A phase one study of the hepatic arterial administration of 1,25-dihydroxyvitamin D3 for liver cancers. Journal of Gastroenterology and Hepatology 16:3, 333-337
CrossRef73
Johannes P.T.M. van Leeuwen, Gert-Jan C.M. van den Bemd, Marjolein van Driel, Cok J. Buurman, Huibert A.P. Pols. (2001) 24,25-Dihydroxyvitamin D3 and bone metabolism. Steroids 66:3-5, 375-380
CrossRef74
Sarah L. Morgan. (2001) Calcium and Vitamin D in Osteoporosis. Rheumatic Disease Clinics of North America 27:1, 101-130
CrossRef75
Opinder Sahota, David J. Hosking. (2001) The contribution of nutritional factors to osteopenia in the elderly. Current Opinion in Clinical Nutrition and Metabolic Care 4:1, 15-20
CrossRef76
J.E Compston. (2000) Pharmacological interventions for the prevention of vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: does site-specificity exist?. Bone 27:6, 765-768
CrossRef77
David Hunter, Philippa Major, Nigel Arden, R. Swaminathan, Toby Andrew, Alexander J. MacGregor, Richard Keen, Harold Snieder, Tim D. Spector. (2000) A Randomized Controlled Trial of Vitamin D Supplementation on Preventing Postmenopausal Bone Loss and Modifying Bone Metabolism Using Identical Twin Pairs. Journal of Bone and Mineral Research 15:11, 2276-2283
CrossRef78
T Nishikawa, S Ogawa, K Kogita, N Manabe, T Katsumata, K Nakamura, H Kawaguchi. (2000) Additive effects of combined treatment with etidronate and alfacalcidol on bone mass and mechanical properties in ovariectomized rats. Bone 27:5, 647-654
CrossRef79
Marc Hochberg. (2000) Preventing Fractures in Postmenopausal Women with Osteoporosis. Drugs & Aging 17:4, 317-330
CrossRef80
Juliet Compston. (2000) Prevention of osteoporotic fractures in post-menopausal women. Best Practice & Research Clinical Endocrinology & Metabolism 14:2, 251-264
CrossRef81
Ego Seeman. (2000) Selection of individuals for prevention of fractures due to bone fragility. Best Practice & Research Clinical Endocrinology & Metabolism 14:2, 233-249
CrossRef82
Ayako Shiraishi, Satoshi Takeda, Toshimi Masaki, Yoshinobu Higuchi, Yasushi Uchiyama, Noboru Kubodera, Katsuhiko Sato, Kyoji Ikeda, Toshitaka Nakamura, Toshio Matsumoto, Etsuro Ogata. (2000) Alfacalcidol Inhibits Bone Resorption and Stimulates Formation in an Ovariectomized Rat Model of Osteoporosis: Distinct Actions from Estrogen. Journal of Bone and Mineral Research 15:4, 770-779
CrossRef83
Yoshiji Yamada, Atsushi Harada, Takayuki Hosoi, Akimitsu Miyauchi, Kyoji Ikeda, Hiroaki Ohta, Masataka Shiraki. (2000) Association of Transforming Growth Factor β1 Genotype with Therapeutic Response to Active Vitamin D for Postmenopausal Osteoporosis. Journal of Bone and Mineral Research 15:3, 415-420
CrossRef84
B. Ongphiphadhanakul, N. Piaseu, S.Sae Tung, L. Chailurkit, R. Rajatanavin. (2000) Prevention of postmenopausal bone loss by low and conventional doses of calcitriol or conjugated equine estrogen. Maturitas 34:2, 179-184
CrossRef85
Yoshihiro Sato. (2000) Abnormal bone and calcium metabolism in patients after stroke. Archives of Physical Medicine and Rehabilitation 81:1, 117-121
CrossRef86
Robert D. Blank, Richard S. Bockman. (1999) A Review of Clinical Trials of Therapies for Osteoporosis Using Fracture as an End Point. Journal of Clinical Densitometry 2:4, 435-452
CrossRef87
1999. Dairy Foods and Osteoporosis. .
CrossRef88
Nathaniel W Liggett, David M Reid. (1999) The non-hormonal treatment of osteoporosis. The Obstetrician & Gynaecologist 1:1, 7-11
CrossRef89
C. Brot, N. Jorgensen, O. R. Madsen, L. B. Jensen, O. H. Sorensen. (1999) Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women. Journal of Internal Medicine 245:5, 509-516
CrossRef90
C. A. Brand, D. Jolley, M. Tellus, K. D. Muirden, J. D. Wark. (1999) Risk factors for osteoporosis and fracture in patients attending rheumatology outpatient clinics. Australian and New Zealand Journal of Medicine 29:2, 197-202
CrossRef91
Y Sato, K Oizumi, H Kuno, M Kaji. (1999) Effect of immobilization upon renal synthesis of 1,25-dihydroxyvitamin D in disabled elderly stroke patients. Bone 24:3, 271-275
CrossRef92
B. E. CHRISTOPHER NORDIN, ALLAN G. NEED, TRACY STEURER, HOWARD A. MORRIS, BARRY E. CHATTERTON, MICHAEL HOROWITZ. (1998) Nutrition, Osteoporosis, and Aging. Annals of the New York Academy of Sciences 854:1 TOWARDS PROLO, 336-351
CrossRef93
(1998) Treatment of Postmenopausal Osteoporosis. New England Journal of Medicine 339:3, 202-203
Full Text94
G. MATHUR, P. CLIFTON-BLIGH, G. FULCHER, J. STIEL, A. McELDUFF. (1998) Calcitriol in osteoporosis - is it used safely?. Australian and New Zealand Journal of Medicine 28:3, 348-349
CrossRef95
Wood, Alastair J.J., , Eastell, Richard, . (1998) Treatment of Postmenopausal Osteoporosis. New England Journal of Medicine 338:11, 736-746
Full Text96
K. Brixen, T.B. Hansen, E.F. Eriksen, L. Mosekilde. (1998) Does growth hormone therapy in adult patients with growth hormone deficiency protect against bone loss?. Growth Hormone & IGF Research 8, 81-86
CrossRef97
Karl J Obrant. (1998) Prevention of osteoporotic fractures-should orthopedic surgeons care?. Acta Orthopaedica 69:4, 333-338
CrossRef98
Barry S. Komm, Peter V.N. Bodine. (1998) The ongoing saga of osteoporosis treatment. Journal of Cellular Biochemistry 72:S30-31, 277-283
CrossRef99
D. Henry, J. Robertson, D. O'connell, W. Gillespie. (1998) A systematic review of the skeletal effects of estrogen therapy in postmenopausal women. I. An assessment of the quality of randomized trials published between 1977 and 1995. Climacteric 1:2, 92-111
CrossRef100
Joseph M. Lane. (1997) Osteoporosis. Spine 22:Supplement, 32S-37S
CrossRef101
C. WHITEHEAD, P. FINUCANE. (1997) Reply. Australian and New Zealand Journal of Medicine 27:4, 445-445
CrossRef102
L. FLICKER, M. STEIN, S. SCHERER, C. NOWSON, J. WARK. (1997) Malnutrition in elderly people. Australian and New Zealand Journal of Medicine 27:4, 444-444
CrossRef103
D.R. Dirschl, R.C. Henderson, W.C. Oakley. (1997) Accelerated bone mineral loss following a hip fracture: A prospective longitudinal study. Bone 21:1, 79-82
CrossRef104
B.E.Christopher Nordin. (1997) Calcium and osteoporosis. Nutrition 13:7-8, 664-686
CrossRef105
J.-T. Chen, M. Shiraki, K. Hasumi, N. Tanaka, K. Katase, T. Kato, Y. Hirai, T. Nakamura, E. Ogata. (1997) 1-α-Hydroxyvitamin D3 treatment decreases bone turnover and modulates calcium-regulating hormones in early postmenopausal women. Bone 20:6, 557-562
CrossRef106
I. Žofková, R.L. Kancheva. (1997) The effect of 1,25(OH)2 vitamin D3 on subsets of T lymphocytes in postmenopausal women. Life Sciences 61:2, 147-152
CrossRef107
H. F. Deluca. (1997) 1,25-Dihydroxyvitamin D3 in the pathogenesis and treatment of osteoporosis. Osteoporosis International 7:S3, 24-29
CrossRef108
J. A. Kanis, E. V. McCloskey, D. Takats, J. Bernard, D. M. Zhang. (1997) Treatment of osteoporosis with vitamin D. Osteoporosis International 7:S3, 140-146
CrossRef109
C. Christiansen. (1997) The strategy for the treatment of osteoporosis. Osteoporosis International 7:S3, 147-149
CrossRef110
T. Nakamura. (1997) Vitamin D for the treatment of osteoporosis. Osteoporosis International 7:S3, 155-158
CrossRef111
Danilo Fliser, Edward Franek, Markus Joest, Stefan Block, Ernst Mutschler, Eberhard Ritz. (1997) Renal function in the elderly: Impact of hypertension and cardiac function. Kidney International 51:4, 1196-1204
CrossRef112
M. A. Dambacher, M. Kranich, E. Schacht, M. Neff. (1997) Can the fast bone loss in osteoporotic and osteopenic patients be stopped with active vitamin D metabolites?. Calcified Tissue International 60:1, 115-118
CrossRef113
(1996) Bone Disease in Older People: Prevention and Treatment. Australasian Journal on Ageing 15, 22-23
CrossRef114
W. Radkohl, G. Leb. (1996) Osteoporose und Hormonersatztherapie. European Surgery 28:5, 263-265
CrossRef115
John G. Haddad. (1996) Seasonal diminution of vitamin D stores in the United States. Can darker winters lead to lighter bones?. Trends in Endocrinology & Metabolism 7:6, 209-212
CrossRef116
Akifumi Tokitan, Hiroshi Matsumoto, Nigel A. Morrison, Toshiya Tawa, Yuko Miura, Kazutaka Fukamauchi, Naoki Mitsuhashi, Masahiro Irimoto, Syunji Yamamori, Masakazu Miura, Takako Watanabe, Yoshihiro Kuwabara, Keijiro Yabuta, John A. Eisman. (1996) Vitamin D receptor alleles, bone mineral density and turnover in premenopausal Japanese women. Journal of Bone and Mineral Research 11:7, 1003-1009
CrossRef117
JENNY HEATHCOTE. (1996) Review: Treatment of primary biliary cirrhosis. Journal of Gastroenterology and Hepatology 11:7, 605-609
CrossRef118
J Gram. (1996) Dose-response effect of short-term calcitriol treatment on bone and mineral metabolism in normal males. Bone 18:6, 539-544
CrossRef119
Rauno Heikinheimo, Harri Sievänen, Pirkko Jäntti, Päivi-Liisa Mäki-Jokela, Sulo Rajala, Ilkka Vuori. (1996) Vitamin D treatment and bone mineral density in the aged. Maturitas 23, S77-S80
CrossRef120
P. Lips. (1996) Prevention of hip fractures: Drug therapy. Bone 18:3, S159-S163
CrossRef121
John D. Wark. (1996) Osteoporotic fractures: background and prevention strategies. Maturitas 23:2, 193-207
CrossRef122
B.L. Riggs, L.J. Melton, W.M. O'Fallon. (1996) Drug therapy for vertebral fractures in osteoporosis: Evidence that decreases in bone turnover and increases in bone mass both determine antifracture efficacy. Bone 18:3, S197-S201
CrossRef123
O. H. Sorensen, J-E. B. Jensen, G. Kollerup, H. A. Sorensen, L. B. Jensen. (1996) To Screen or not to Screen?. Scandinavian Journal of Rheumatology 25:s103, 25-29
CrossRef124
Gert-Jan C.M. van den Bemd, Huibert A.P. Pols, Jan C. Birkenha¨ger, Wendy M.C. Kleinekoort, Johannes P.T.M. van Leeuwen. (1995) Differential effects of 1,25-dihydroxyvitamin D3-analogs on osteoblast-like cells and onin vitro bone resorption. The Journal of Steroid Biochemistry and Molecular Biology 55:3-4, 337-346
CrossRef125
Liberman, Uri A., Weiss, Stuart R., Bröll, Johann, Minne, Helmut W., Quan, Hui, Bell, Norman H., Rodriguez-Portales, Jose, Downs, Robert W. Jr., Dequeker, Jan, Favus, Murray, Seeman, Ego, Recker, Robert R., Capizzi, Thomas, Santora, Arthur C., Lombardi, Antonio, Shah, Raksha V., Hirsch, Laurence J., Karpf, David B., . (1995) Effect of Oral Alendronate on Bone Mineral Density and the Incidence of Fractures in Postmenopausal Osteoporosis. New England Journal of Medicine 333:22, 1437-1444
Full Text126
Sambrook, Philip N., . (1995) The Treatment of Postmenopausal Osteoporosis. New England Journal of Medicine 333:22, 1495-1496
Full Text127
R. J. Erdtsieck, H. A. P. Pols, N. K. Valk, B. M. Ouwerkerk, S. W. J. Lamberts, P. Mulder, J. C. Birkenhäger. (1995) Treatment of post-menopausal osteoporosis with a combination of growth hormone and pamidronate: a placebo controlled trial. Clinical Endocrinology 43:5, 557-565
CrossRef128
Juliet E. Compston. (1995) The role of vitamin D and calcium supplementation in the prevention of osteoporotic fractures in the elderly. Clinical Endocrinology 43:4, 393-405
CrossRef129
J. M. Kaufman. (1995) Role of calcium and vitamin D in the prevention and the treatment of postmenopausal osteoporosis: An overview. Clinical Rheumatology 14:S3, 9-13
CrossRef130
E. Seeman, C. Tsalamandris, S. Bass, G. Pearce. (1995) Present and future of osteoporosis therapy. Bone 17:2, S23-S29
CrossRef131
Timothy Lohman, Scott Going, Matthew Hall, Cheryl Ritenbaugh, Lisa Bare, Anabel Hill, Linda Houtkooper, Mikel Aickin, Thomas Boyden, Richard Pamenter. (1995) Effects of resistance training on regional and total bone mineral density in premenopausal women: A randomized prospective study. Journal of Bone and Mineral Research 10:7, 1015-1024
CrossRef132
D. Schapira, S. Linn, M. Sarid, S. Mokadi, A. Kabala, M. Silbermann. (1995) Calcium and vitamin D enriched diets increase and preserve vertebral mineral content in aging laboratory rats. Bone 16:5, 575-582
CrossRef133
Felicia Cosman, Jeri Nieves, Victor Shen, Robert Lindsay. (1995) Oral 1,25-dihydroxyvitamin D administration in osteoporotic women: Effects of estrogen therapy. Journal of Bone and Mineral Research 10:4, 594-600
CrossRef134
Robert Scragg, Ian Holdaway, Vijay Singh, Patricia Metcalf, John Baker, Evan Dryson. (1995) Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Research and Clinical Practice 27:3, 181-188
CrossRef135
H. Rico, M. Revilla, E. R. Hern
ndez, L. F. Villa, M. Alvarez Buergo. (1995) Total and regional bone mineral content and fracture rate in postmenopausal osteoporosis treated with salmon calcitonin: A prospective study. Calcified Tissue International 56:3, 181-185
CrossRef136
Ego Seeman. (1995) The dilemma of osteoporosis in men. The American Journal of Medicine 98:2, 76S-88S
CrossRef137
John A. Eisman. (1995) Efficacy of treatment of osteoporotic fractures. The American Journal of Medicine 98:2, 17S-23S
CrossRef138
Karen M. Prestwood, M.D, Carol C. Pilbeam, M.D, Lawrence G. Raisz, M.D. (1995) TREATMENT OF OSTEOPOROSIS. Annual Review of Medicine 46:1, 249-256
CrossRef139
Olof Johnell. (1995) Prevention of fractures in the elderly: A review. Acta Orthopaedica 66:1, 90-98
CrossRef140
J. A. Kanis, J. A. Kanis. (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report. Osteoporosis International 4:6, 368-381
CrossRef141
H. Orimo, M. Shiraki, Y. Hayashi, T. Hoshino, T. Onaya, S. Miyazaki, H. Kurosawa, T. Nakamura, N. Ogawa. (1994) Effects of 1?-hydroxyvitamin D3 on lumbar bone mineral density and vertebral fractures in patients with postmenopausal osteoporosis. Calcified Tissue International 54:5, 370-376
CrossRef142
J.C. Gallagher, Charles W. Bishop, Joyce C. Knutson, Richard B. Mazess, Hector F. Deluca. (1994) Effects of increasing doses of 1α-hydroxyvitamin D2 on calcium homeostasis in postmenopausal osteopenic women. Journal of Bone and Mineral Research 9:5, 607-614
CrossRef143
Alfred Maelicke. (1994) Osteoporose. Nachrichten aus Chemie, Technik und Laboratorium 42:4, 400-400
CrossRef144
B.L. Riggs, W.M. O'Fallon, A. Lane, S.F. Hodgson, H.W. Wahner, J. Muhs, E. Chao, L.J. Melton. (1994) Clinical trial of fluoride therapy in postmenopausal osteoporotic women: Extended observations and additional analysis. Journal of Bone and Mineral Research 9:2, 265-275
CrossRef145
Hui Quan, Weichung J. Shih, Thomas Capizzi. (1994) A two-stage sequential design and analysis for comparing binomial rates with possibly random dropouts. Communications in Statistics - Theory and Methods 23:2, 467-484
CrossRef146
J.M. Quesada, A. Mateo, I. Jans, M. Rodriguez, R. Bouillon. (1994) Calcitriol corrects deficient calcitonin secretion in the vitamin D-deficient elderly. Journal of Bone and Mineral Research 9:1, 53-57
CrossRef147
Patrick Ruedin, Rene Rizzoli, Daniel Slosman, Michel Leski, Jean-Philippe Bonjour. (1994) Effects of oral calcitriol on bone mineral density in patients with end-stage renal failure. Kidney International 45:1, 245-252
CrossRef148
Masami Okabe, Ruen-Chu Sun. (1993) An efficient synthesis of (22E,25R)-1α,25,26-trihydroxy-Δ22-Vitamin D3. Tetrahedron Letters 34:41, 6533-6536
CrossRef149
T. OLBRICHT, G. BENKER. (1993) Glucocorticoid-induced osteoporosis: pathogenesis, prevention and treatment, with special regard to the rheumatic diseases. Journal of Internal Medicine 234:3, 237-244
CrossRef150
John A Kanis, Jean Aaron, Monique Benéton, Eugene McCloskey. (1993) Treatment of osteoporosis. Journal of Bone and Mineral Metabolism 11:1, S17-S24
CrossRef151
Bess Dawson-Hughes, Susan Harris, Carolyn Kramich, Gerard Dallal, Helen M. Rasmussen. (1993) Calcium retention and hormone levels in black and white women on high- and low-calcium diets. Journal of Bone and Mineral Research 8:7, 779-787
CrossRef152
Sambrook, PhilipBirmingham, JoanKelly, PaulKempler, SusanNguyen, TuanPocock, NicholasEisman, John. (1993) Prevention of Corticosteroid Osteoporosis -- A Comparison of Calcium, Calcitriol, and Calcitonin. New England Journal of Medicine 328:24, 1747-1752
Full Text153
Douglas J. Marchant. (1993) Estrogen-replacement therapy after breast cancer risks versus benefits. Cancer 71:S6, 2169-2176
CrossRef154
Chapuy, Marie C., Arlot, Monique E., Duboeuf, François, Brun, Jacqueline, Crouzet, Brigitte, Arnaud, Simone, Delmas, Pierre D., Meunier, Pierre J., . (1992) Vitamin D3 and Calcium to Prevent Hip Fractures in Elderly Women. New England Journal of Medicine 327:23, 1637-1642
Full Text155
Flavia Pietschmann, Neil A. Breslau, Charles Y.C. Pak. (1992) Reduced vertebral bone density in hypercalciuric nephrolithiasis. Journal of Bone and Mineral Research 7:12, 1383-1388
CrossRef156
R. Koren, A. Ravid, U.A. Liberman, R. Narinsky, L. Maron, M. Weisman, R. Samuel. (1992) Responsiveness to 1,25-Dihydroxyvitamin D3 is reduced in lymphocytes from osteoporotic women. Journal of Bone and Mineral Research 7:9, 1057-1061
CrossRef157
Wood, Alastair J.J., , Riggs, B. Lawrence, Melton, L. Joseph III, . (1992) The Prevention and Treatment of Osteoporosis. New England Journal of Medicine 327:9, 620-627
Full Text158
(1992) Calcitriol or Calcium for Postmenopausal Osteoporosis. New England Journal of Medicine 327:4, 284-284
Full Text159
Chesnut, Charles H. III, . (1992) Osteoporosis and Its Treatment. New England Journal of Medicine 326:6, 406-408
Full Text
- Letters
