open access

Vol 74, No 1 (2023)
Review paper
Submitted: 2022-12-09
Accepted: 2022-12-20
Published online: 2023-02-15
Get Citation

The content of this article is also available in the following languages:
Polski

Clinical efficacy and safety of use of alfacalcidol and calcitriol in daily endocrinological practice

Michał Stuss1, Marta Michalska-Kasiczak1, Ewa Sewerynek1
·
Pubmed: 36847721
·
Endokrynol Pol 2023;74(1):16-24.
Affiliations
  1. Department of Endocrine Disorders and Bone Metabolism, Medical University of Lodz, Lodz, Poland

open access

Vol 74, No 1 (2023)
Review Article
Submitted: 2022-12-09
Accepted: 2022-12-20
Published online: 2023-02-15

Abstract

This paper aims to discuss and compare 2 vitamin D derivatives available on the Polish market, alfacalcidol and calcitriol, in the context of their effectiveness and safety in endocrine patients. Both above-mentioned substances find a number of applications, including in hypoparathyroidism, which is one of the most common indications for their use. We would also like to draw the reader’s attention to the fact that there are quite a lot of reports in the literature on the positive effect of alfacalcidol and calcitriol on maintaining bone mass and the risk of fractures, which may bring additional potential benefits to our patients.

Abstract

This paper aims to discuss and compare 2 vitamin D derivatives available on the Polish market, alfacalcidol and calcitriol, in the context of their effectiveness and safety in endocrine patients. Both above-mentioned substances find a number of applications, including in hypoparathyroidism, which is one of the most common indications for their use. We would also like to draw the reader’s attention to the fact that there are quite a lot of reports in the literature on the positive effect of alfacalcidol and calcitriol on maintaining bone mass and the risk of fractures, which may bring additional potential benefits to our patients.

Get Citation

Keywords

alfacalcidol; calcitriol; endocrinology; hypoparathyroidism; hypocalcaemia

About this article
Title

Clinical efficacy and safety of use of alfacalcidol and calcitriol in daily endocrinological practice

Journal

Endokrynologia Polska

Issue

Vol 74, No 1 (2023)

Article type

Review paper

Pages

16-24

Published online

2023-02-15

Page views

3545

Article views/downloads

2966

DOI

10.5603/EP.a2023.0008

Pubmed

36847721

Bibliographic record

Endokrynol Pol 2023;74(1):16-24.

Keywords

alfacalcidol
calcitriol
endocrinology
hypoparathyroidism
hypocalcaemia

Authors

Michał Stuss
Marta Michalska-Kasiczak
Ewa Sewerynek

References (49)
  1. Rodriguez M, Munoz-Castaneda JR, Almaden Y. Therapeutic use of calcitriol. Curr Vasc Pharmacol. 2014; 12(2): 294–299.
  2. Jones G, Kottler ML, Schlingmann KP. Genetic Diseases of Vitamin D Metabolizing Enzymes. Endocrinol Metab Clin North Am. 2017; 46(4): 1095–1117.
  3. Schlingmann KP, Kaufmann M, Weber S, et al. Mutations in CYP24A1 and idiopathic infantile hypercalcemia. N Engl J Med. 2011; 365(5): 410–421.
  4. Anderson PH. Vitamin D Activity and Metabolism in Bone. Curr Osteoporos Rep. 2017; 15(5): 443–449.
  5. Piri F, Khosravi A, Moayeri A, et al. The Effects of Dietary Supplements of Calcium, Vitamin D and Estrogen Hormone on Serum Levels of OPG and RANKL Cytokines and their Relationship with Increased Bone Density in Rats. J Clin Diagn Res. 2016; 10(9): AF01–AF04.
  6. Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357(3): 266–281.
  7. Carlberg C. Molecular endocrinology of vitamin D on the epigenome level. Mol Cell Endocrinol. 2017; 453: 14–21.
  8. Carlberg C, Haq A. The concept of the personal vitamin D response index. J Steroid Biochem Mol Biol. 2018; 175: 12–17.
  9. Wu W, Beilhartz G, Roy Y, et al. Nuclear translocation of the 1,25D3-MARRS (membrane associated rapid response to steroids) receptor protein and NFkappaB in differentiating NB4 leukemia cells. Exp Cell Res. 2010; 316(7): 1101–1108.
  10. Khanal R, Nemere I. Membrane receptors for vitamin D metabolites. Crit Rev Eukaryot Gene Expr. 2007; 17(1): 31–47.
  11. Pludowski P, Holick MF, Grant WB, et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol. 2018; 175: 125–135.
  12. Detriol — characteristics of the medicinal product. https://www.ptendo.org.pl/upl/browser/files/rozne/Detriol-ChPL.pdf.
  13. Kravvas G, Gholam K. Use of topical therapies for pediatric psoriasis: A systematic review. Pediatr Dermatol. 2018; 35(3): 296–302.
  14. Dechant KL, Goa KL. Calcitriol. A review of its use in the treatment of postmenopausal osteoporosis and its potential in corticosteroid-induced osteoporosis. Drugs Aging. 1994; 5(4): 300–317.
  15. Jones G, Prosser DE, Kaufmann M. 25-Hydroxyvitamin D-24-hydroxylase (CYP24A1): its important role in the degradation of vitamin D. Arch Biochem Biophys. 2012; 523(1): 9–18.
  16. Cianferotti L, Cricelli C, Kanis JA, et al. The clinical use of vitamin D metabolites and their potential developments: a position statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF). Endocrine. 2015; 50(1): 12–26.
  17. Richy F, Deroisy R, Lecart MP, et al. D-hormone analog alfacalcidol: an update on its role in post-menopausal osteoporosis and rheumatoid arthritis management. Aging Clin Exp Res. 2005; 17(2): 133–142.
  18. LEO Pharma Inc. Product Monograph: ONE-ALPHA (alfacalcidol), for oral and intravenous use. https://pdf.hres.ca/dpd_pm/00040724.PDF.
  19. Alfadiol — characteristics of the medicinal product. https://pl.gsk.com/media/7377/alfadiol-0-25-mcg-chpl-gsk-psc-poland-10122021.pdf.
  20. Obara-Moszynska M, Rojek A, Kolesinska Z, et al. X-linked hypophosphataemic rickets in children: clinical phenotype, therapeutic strategies, and molecular background. Endokrynol Pol. 2021; 72(2): 108–119.
  21. Mazzaferro S, Goldsmith D, Larsson TE, et al. Vitamin D metabolites and/or analogs: which D for which patient? Curr Vasc Pharmacol. 2014; 12(2): 339–349.
  22. Ringe JD, Schacht E. Potential of alfacalcidol for reducing increased risk of falls and fractures. Rheumatol Int. 2009; 29(10): 1177–1185.
  23. Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015; 173(2): G1–20.
  24. Khan AA, Koch CA, Van Uum S, et al. Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus. Eur J Endocrinol. 2019; 180(3): P1–P22.
  25. Brandi ML, Bilezikian JP, Shoback D, et al. Management of Hypoparathyroidism: Summary Statement and Guidelines. J Clin Endocrinol Metab. 2016; 101(6): 2273–2283.
  26. Ebeling PR, Adler RA, Jones G, et al. Management of Endocrine disease: Therapeutics of Vitamin D. Eur J Endocrinol. 2018; 179(5): R239–R259.
  27. Saha S, Sreenivas V, Goswami R. Alfacalcidol vs Calcitriol in the Management of Patient With Hypoparathyroidism: A Randomized Controlled Trial. J Clin Endocrinol Metab. 2021; 106(7): 2092–2102.
  28. Brandi L, Egfjord M, Olgaard K. Pharmacokinetics of 1,25(OH)(2)D(3) and 1alpha(OH)D(3) in normal and uraemic men. Nephrol Dial Transplant. 2002; 17(5): 829–842.
  29. Nuti R, Bianchi G, Brandi ML, et al. Superiority of alfacalcidol compared to vitamin D plus calcium in lumbar bone mineral density in postmenopausal osteoporosis. Rheumatol Int. 2006; 26(5): 445–453.
  30. Papadimitropoulos E, Wells G, Shea B, et al. Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group. Meta-analyses of therapies for postmenopausal osteoporosis. VIII: Meta-analysis of the efficacy of vitamin D treatment in preventing osteoporosis in postmenopausal women. Endocr Rev. 2002; 23(4): 560–569.
  31. Tanizawa T, Imura K, Ishii Y, et al. Treatment with active vitamin D metabolites and concurrent treatments in the prevention of hip fractures: a retrospective study. Osteoporos Int. 1999; 9(2): 163–170.
  32. Avenell A, Mak JCS, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014; 2014(4): CD000227.
  33. Deng J, Silver Z, Huang E, et al. The effect of calcium and vitamin D compounds on bone mineral density in patients undergoing glucocorticoid therapies: a network meta-analysis. Clin Rheumatol. 2021; 40(2): 725–734.
  34. O'Donnell S, Moher D, Thomas K, et al. Systematic review of the benefits and harms of calcitriol and alfacalcidol for fractures and falls. J Bone Miner Metab. 2008; 26(6): 531–542.
  35. Brancatella A, Cappellani D, Vignali E, et al. Calcifediol Rather Than Cholecalciferol for a Patient Submitted to Malabsortive Bariatric Surgery: A Case Report. J Endocr Soc. 2017; 1(8): 1079–1084.
  36. Kupisz-Urbańska M, Stuss M, Kuryłowicz A, et al. Fracture risk in obesity: a narrative review. Endokrynol Pol. 2022; 73(5): 885–892.
  37. Mendonça FM, Soares R, Carvalho D, et al. The impact of obesity on bone health: an overview. Endokrynol Pol. 2022; 73(6): 954–958.
  38. Akeno N, Matsunuma A, Maeda T, et al. Regulation of vitamin D-1alpha-hydroxylase and -24-hydroxylase expression by dexamethasone in mouse kidney. J Endocrinol. 2000; 164(3): 339–348.
  39. Kurahashi I, Matsunuma A, Kawane T, et al. Dexamethasone enhances vitamin D-24-hydroxylase expression in osteoblastic (UMR-106) and renal (LLC-PK1) cells treated with 1alpha,25-dihydroxyvitamin D3. Endocrine. 2002; 17(2): 109–118.
  40. Ortego-Jurado M, Callejas-Rubio JL, Ríos-Fernández R, et al. Oral Calcidiol Is More Effective Than Cholecalciferol Supplementation to Reach Adequate 25(OH)D Levels in Patients with Autoimmune Diseases Chronically Treated with Low Doses of Glucocorticoids: A "Real-Life" Study. J Osteoporos. 2015; 2015: 729451.
  41. Ringe JD, Dorst A, Faber H, et al. Superiority of alfacalcidol over plain vitamin D in the treatment of glucocorticoid-induced osteoporosis. Rheumatol Int. 2004; 24(2): 63–70.
  42. Richy F, Schacht E, Bruyere O, et al. Vitamin D analogs versus native vitamin D in preventing bone loss and osteoporosis-related fractures: a comparative meta-analysis. Calcif Tissue Int. 2005; 76(3): 176–186.
  43. Richy F, Ethgen O, Bruyere O, et al. Efficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate. Osteoporos Int. 2004; 15(4): 301–310.
  44. Jing W, Dai Y, Zhu J, et al. Clinical Efficacy and Safety Evaluation of Calcitriol Combined with Bisphosphonates in the Therapy of Postmenopausal Osteoporosis: Based on a Retrospective Cohort Study. Biomed Res Int. 2022; 2022: 2711938.
  45. Orimo H, Nakamura T, Fukunaga M, et al. A-TOP (Adequate Treatment of Osteoporosis) research group. Effects of alendronate plus alfacalcidol in osteoporosis patients with a high risk of fracture: the Japanese Osteoporosis Intervention Trial (JOINT) - 02. Curr Med Res Opin. 2011; 27(6): 1273–1284.
  46. Shao HB, Yao YM, Wang ZY, et al. Effects of combined alendronate and alfacalcidol on prevention of fractures in osteoporosis patients: a network meta-analysis. Int J Clin Exp Med. 2015; 8(8): 12935–12941.
  47. Ringe JD, Farahmand P, Schacht E, et al. Superiority of a combined treatment of Alendronate and Alfacalcidol compared to the combination of Alendronate and plain vitamin D or Alfacalcidol alone in established postmenopausal or male osteoporosis (AAC-Trial). Rheumatol Int. 2007; 27(5): 425–434.
  48. Ebina K, Kashii M, Hirao M, et al. Comparison of the effects of denosumab between a native vitamin D combination and an active vitamin D combination in patients with postmenopausal osteoporosis. J Bone Miner Metab. 2017; 35(5): 571–580.
  49. One-Alpha — characteristics of the medicinal product. https://www.medicines.org.uk/emc/product/5516/smpc#gref.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą jest  VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl