Vitamin D Status in Paget Disease of Bone and Efficacy–Safety Profile of Cholecalciferol Treatment in Pagetic Patients with Hypovitaminosis D

Adequate vitamin D status is essential for skeletal health. Paget’s disease of bone (PDB) is a common metabolic skeletal disorder, but data regarding the vitamin D status in PDB patients are lacking. We performed a case–control study to estimate vitamin D status in 708 PDB patients and in 1803 healt...

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Published in:Calcified tissue international 2019-10, Vol.105 (4), p.412-422
Main Authors: Rendina, Domenico, De Filippo, Gianpaolo, Merlotti, Daniela, Di Stefano, Marco, Succoio, Mariangela, Muggianu, Simona Maria, Bianciardi, Simone, D’Elia, Lanfranco, Coppo, Eleonora, Faraonio, Raffaella, Nuti, Ranuccio, Strazzullo, Pasquale, Gennari, Luigi
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Language:English
Subjects:
Biochemistry
Biomedical and Life Sciences
Cell Biology
Endocrinology
Life Sciences
Metabolism
Nephrolithiasis
Original Research
Orthopedics
Pain
Parathyroid hormone
Quality of life
Risk factors
Vitamin D
Vitamin deficiency
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creator Rendina, Domenico
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Merlotti, Daniela
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Muggianu, Simona Maria
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D’Elia, Lanfranco
Coppo, Eleonora
Faraonio, Raffaella
Nuti, Ranuccio
Strazzullo, Pasquale
Gennari, Luigi
description Adequate vitamin D status is essential for skeletal health. Paget’s disease of bone (PDB) is a common metabolic skeletal disorder, but data regarding the vitamin D status in PDB patients are lacking. We performed a case–control study to estimate vitamin D status in 708 PDB patients and in 1803 healthy controls from Italy and an observational prospective study to evaluate the efficacy–safety profile of oral cholecalciferol treatment [400.000 International Units (UI) of cholecalciferol administered in cycles of 8 weeks until 25OHD levels reaches 70 nmol/L as primary therapy and 50.000 UI of cholecalciferol administered every 2 weeks for 52 weeks for the maintenance therapy] in 82 PDB patients with hypovitaminosis D, i.e., 25OHD 
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Paget’s disease of bone (PDB) is a common metabolic skeletal disorder, but data regarding the vitamin D status in PDB patients are lacking. We performed a case–control study to estimate vitamin D status in 708 PDB patients and in 1803 healthy controls from Italy and an observational prospective study to evaluate the efficacy–safety profile of oral cholecalciferol treatment [400.000 International Units (UI) of cholecalciferol administered in cycles of 8 weeks until 25OHD levels reaches 70 nmol/L as primary therapy and 50.000 UI of cholecalciferol administered every 2 weeks for 52 weeks for the maintenance therapy] in 82 PDB patients with hypovitaminosis D, i.e., 25OHD &lt; 50 nmol/L. The main outcome measures for the prospective study were 25OHD levels, metabolic risk factors (RF) for nephrolithiasis, bone pain score (BPS), and pain medication score (PMS). Over half of PDB patients had hypovitaminosis D. Among PDB patients treated with cholecalciferol, 76 patients reached 25OHD levels ≥ 70 nmol/L after the first cycle of primary therapy and the remaining six patients after a second cycle. The maintenance therapy guaranteed 25OHD levels ≥ 70 nmol/L during the entire follow-up. The increase in 25OHD levels reduced PTH, BPS, and PMS levels, without changes in RF for nephrolithiasis. We can conclude that (i) hypovitaminosis D is frequent in PDB patients, (ii) cholecalciferol significantly increased 25OHD levels in PDB patients, and (iii) the correction of hypovitaminosis D improves the quality of life of PDB patients without inducing significant changes in RF for nephrolithiasis.</description><identifier>ISSN: 0171-967X</identifier><identifier>EISSN: 1432-0827</identifier><identifier>DOI: 10.1007/s00223-019-00578-1</identifier><identifier>PMID: 31236621</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biochemistry ; Biomedical and Life Sciences ; Cell Biology ; Endocrinology ; Life Sciences ; Metabolism ; Nephrolithiasis ; Original Research ; Orthopedics ; Pain ; Parathyroid hormone ; Quality of life ; Risk factors ; Vitamin D ; Vitamin deficiency</subject><ispartof>Calcified tissue international, 2019-10, Vol.105 (4), p.412-422</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Calcified Tissue International is a copyright of Springer, (2019). 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Among PDB patients treated with cholecalciferol, 76 patients reached 25OHD levels ≥ 70 nmol/L after the first cycle of primary therapy and the remaining six patients after a second cycle. The maintenance therapy guaranteed 25OHD levels ≥ 70 nmol/L during the entire follow-up. The increase in 25OHD levels reduced PTH, BPS, and PMS levels, without changes in RF for nephrolithiasis. We can conclude that (i) hypovitaminosis D is frequent in PDB patients, (ii) cholecalciferol significantly increased 25OHD levels in PDB patients, and (iii) the correction of hypovitaminosis D improves the quality of life of PDB patients without inducing significant changes in RF for nephrolithiasis.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31236621</pmid><doi>10.1007/s00223-019-00578-1</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-0331-0392</orcidid></addata></record>
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subjects Biochemistry
Biomedical and Life Sciences
Cell Biology
Endocrinology
Life Sciences
Metabolism
Nephrolithiasis
Original Research
Orthopedics
Pain
Parathyroid hormone
Quality of life
Risk factors
Vitamin D
Vitamin deficiency
title Vitamin D Status in Paget Disease of Bone and Efficacy–Safety Profile of Cholecalciferol Treatment in Pagetic Patients with Hypovitaminosis D
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