Vitamin D: Osteoporosis Patients Best Friend

Osteoporosis patients with high vitamin D levels respond to bone mineral density drugs

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) In order to maximize chances of getting a therapeutic response from bisphosphonates, vitamin D levels need to be high.

A recent chart review shows a sevenfold increase in responsiveness to bone mineral density (BMD) drugs in people who had higher than recommended vitamin D levels. The vitamin D level is incredibly important for patients likely to respond to bisphosphonates such as Fosamax and Boniva.

"Increase vitamin D consumption to give bisphosphonates a better chance to work."

Richard Bockman, M.D., Ph.D., chief of the Endocrine Service at Hospital for Special Surgery, who directed the study reports that if the level of 25-Hydroxy vitamin D level is 33 ng/ml and above, patients are more likely to respond to bisphosphonates.

A level of 20 or 30 ng/ml will not optimize a patient's chances to derive a bone density benefit from bisphosphonates. Brockman observes a seven times greater effect is impressive, to say the least.

The study included 160 patients: 89 were responsive to bisphosphonates and 71 were nonresponsive.  Additionally, 42 had decreased BMD, 17 sustained a fracture, and 12 had a persistently low T-score. Only 17 percent of the patients who were responsive to bisphosphonates had vitamin D levels less than 33ng/ml. A whopping 55 percent of patients who were nonresponsive to bisphosphonates had vitamin D levels less than 33 ng/ml.

Patients with very low levels of vitamin had higher nonresponsive rates. Lower levels of vitamin D had an 83 percent nonresponsive rate, vitamin D levels between 20-30 had a 78 percent nonresponsive rate.

Patients with vitamin D levels between 30-40 had a responsive rate of 58 percent and those whose vitamin D levels were above 40 had a 75 percent responsive rate.

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Review Date: 
June 5, 2011
Last Updated:
June 8, 2011