A three-year comparative trial in osteoporosis treatment: Effect of combined alfacalcidol and elcatonin

Abstract

The effect of agents commonly used for osteoporosis treatment in Japan—calcium, alfacalcidol (1α-hydroxyvitamin D3), elcatonin (eel calcitonin derivative), and an alfacalcidol-elcatonin combination—on lumbar spine bone mineral density (BMD) was assessed in 136 subjects aged 51–83 years with various degrees of osteopenia or osteoporosis, divided into five groups approximately matched for age and BMD over a period of 3 years. Lumbar spine BMD decreased by about 3.5% without treatment but was maintained at approximately baseline level on elcatonin. Oral administration of 900mg/day calcium as AAA Ca (active absorbable algae calcium) or 1μg/day alfacalcidol increased lumbar BMD by 4.5% or 3.7%, respectively, after 3 years. Combined use of alfacalcidol and elcatonin was most effective, increasing the BMD by 8.0% after 3 years. Extremely low calcium and vitamin D intake in Japan with consequent low calcitonin secretion may be responsible for the favorable effects. Alfacalcidol, an active form of vitamin D, and elcatonin acting through different mechanisms may act synergistically on bone to increase BMD.