Authors: Stefano Palomba Francesco Orio Tiziana Russo Angela Falbo Achille Tolino Francesco Manguso Vincenzo Nunziata Pasquale Mastrantonio Gaetano Lombardi Fulvio Zullo
Publish Date: 2005/03/01
Volume: 16, Issue: 8, Pages: 943-952
Abstract
Vitamin D receptor VDR gene polymorphisms could be considered one of the factors influencing the efficacy of the antiosteoporotic treatments In this multicenter prospective randomized and controlled trial we evaluated whether BsmI vitamin D receptor VDR genotypes influence the efficacy of antiresorptive treatment regimes administered alone or in combination in postmenopausal osteoporotic women Using restriction endonuclease we identified the BsmI VDR polymorphism in 1100 postmenopausal women with osteoporosis The women were randomized taking account of genotype into five treatment groups 1 alendronate Aln 10 mg/day plus raloxifene Rlx 60 mg/day 2 Aln plus hormone replacement therapy HRT 0625 mg/day conjugated equine estrogens plus 25 mg/day medroxyprogesterone acetate 3 Aln alone 4 HRT alone and 5 Rlx alone Lumbarspine bone mineral density BMD and bone turnover markers were measured at study entry and after 1 year of treatment Using the general linear model GLM repeatedmeasures procedure the means of BMD and bone turnover markers significantly differed from baseline after a period of treatment In particular the mean change from baseline for BMD was −0034 95 confidence interval CI −0037 to −0031 P 0001 for serum osteocalcin OC it was 1369 95 CI 1289 to 1448 P 0001 and for urinary deoxypyridinoline DPD it was 1322 95 CI 1242 to 1401 P 0001 indicating a considerable variation before and after treatment of these indicators In all three cases these effects appeared significantly influenced by treatments genotypes and the treatmentsgenotypes interaction term P 0001 each except for the BMD and genotype effect with P =002 and not by the investigational centers involved in the study In conclusion in postmenopausal osteoporotic women BsmI VDR genotypes influence the efficacy of antiresorptive drugs particularly when used in combinationThis research was supported by the “Programma Operativo Plurifondo POP” Campania Region Italy The authors thank Dr Benito Chinea Ibis Milan and Mrs Jean Ann Gilder Scientific Communication for editing the text No financial support was provided by any pharmaceutical company to realize the present research
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