Alfacalcidol in treatment of osteoporosis and prevention of osteoporotic fractures

Abstract

Literature data about influence of vitamin D deficiency on the structural-functional state of the bone tissue and systems of the organism are analysed. The article contains results of population studies, that the deficiency of D hormone develops a whole spectrum of pathologic conditions, including osteoporosis. On the basis of the analysis of literature it is concluded that an active metabolite of vitamin D, alfacalcidol, is an effective and safe drug, which is characterized by pleiotropic effect and high pharmacological activity versus vitamin D. Treatment with alfacalcidol reduces the risk of falling down, contributes to improvement of muscle strength and makes it possible to minimize side affects. These features together with prevention of the appearance of new fractures, management of pain syndrome, better motor activity and modulation of the immune system contribute to improvement in the life quality of patients, first of all aged and senile ones. Owing to such a complex effect, the use of alfacalcidol in treatment regimens at a therapeutic dose of 1 mcg/day instead of vitamin D with/without calcium reduces the risk of fractures of their vertebral bodies and the risk of peripheral fractures in this group of patients. Active vitamin D metabolites are able both to decelerate bone mass losses in different types of osteoporosis and even to contribute to improvement of the bone quality. Active metabolites are effective for reducing the risk of falling down, particularly in people with creatinine clearance less than 65 ml/min.