Vitamin D3 and calcium supplements reduce hip and nonvertebral fracture rates in elderly women1
In a randomized placebo-controlled study published in the New England Journal of Medicine, 3,270 healthy ambulatory women with a mean [±SD] age of 84±6 years were randomized to 800IU of vitamin D3 and 1.2 g of elemental calcium or placebo for 18 months.
Women who had recently received drugs known to alter bone metabolism were excluded. Women with a history of a fracture and women who had taken or were taking estrogen or a thiazide diuretic were included.
Of the 1,765 women who completed the study, in the treatment vs. the placebo group
(21 vs. 37, P = 0.043)
(66 vs. 97, P = 0.015)
Common side effects* were nausea, diarrhea, or epigastric pain experienced by 40 in the treatment group and 28 in the placebo group —that led to the discontinuation of treatment (P>0.05). One woman in the treatment group developed mild hypercalcemia (11.2 mg per deciliter [2.8 mmol per liter]) that proved to be due to primary hyperparathyroidism.
In conclusion, 18 months of daily supplementation with 1.2 g of elemental calcium and 800 IU of vitamin D3 decreased the incidence of hip fractures and other nonvertebral fractures among elderly women.
*For more information on the adverse event profile of CALCI-D please see the Prescribing Information.
NICE recommend that calcium and/or vitamin D supplementation should be provided to women who receive treatment for osteoporosis, unless clinicians are confident that women have an adequate calcium intake and are vitamin D replete.2
CALCI-D is licensed for correction of calcium and vitamin D deficiency in the elderly. CALCI-D may be used as an adjunct to specific therapy for osteoporosis, in patients with either established vitamin D and calcium combined deficiencies or in those patients at high risk of needing such therapeutic supplements. This study did not use CALCI-D.
1.Chapuy MC et al. N Engl J Med 1992; 327:1637-1642. DOI: 10.1056/NEJM199212033272305
2.National Institute for Health and Care Excellence. Technology appraisal guidance 161. Updated 2018. Available at: http://www.nice.org.uk/guidance/ta161 [Last accessed March 2021].