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Effects of a combined alendronate and calcitriol agent (Maxmarvil) on bone metabolism in Korean postmenopausal women: a multicenter, double-blind, randomized, placebo-controlled study.

Rhee, Y; Kang, M; Min, Y; Byun, D; Chung, Y; Ahn, C; Baek, K; Mok, J; Kim, D; Kim, H; Kim, Y; Myoung, S; Lim, SK
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 17(12):1801-1807, 2006
Journal Title
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
INTRODUCTION: A randomized, double-blind, prospective, 24-week clinical trial was performed to evaluate the effects of a combinative agent, Maxmarvil, of calcitriol (0.5 mug) and alendronate (5 mg) on bone metabolism in postmenopausal women.

METHODS: A total of 217 postmenopausal women with osteoporosis were enrolled; 199 patients were randomly assigned to one of two treatment groups (Maxmarvil group or alfacalcidol group). None of the patients were vitamin-D-deficient, as assessed by serum 25-hydroxyvitamin D (25(OH)D), nor had they received any drugs affecting bone metabolism before enrollment. Bone mineral densities (BMD) of L1-L4 and the femur were measured by dual-energy X-ray absorptiometry (DXA) at the initial assessment and after 6 months of treatment. Serum biochemical assays, including serum calcium, 24-h urinary calcium excretion, and bone turnover markers (both bone-specific alkaline phosphatase [bsALP] and urine N-telopeptide [NTx]), were performed at the baseline and after 3 and 6 months of treatment.

RESULTS: In the Maxmarvil group, the BMD of the lumbar spine increased up to 2.42+/-0.5% from the baseline after 6 months (p<0.05). On the other hand, the change in BMD in the alfacalcidol group was 0.28+/-0.5% after 6 months. There was no significant difference in femoral BMD between the two groups. The levels of bsALP and NTx were significantly lower in the Maxmarvil group than in the alfacalcidol group (-22.04+/-3.9% vs. -11.42+/-2.8% [p<0.05] and -25.46+/-5.2% vs. 1.24+/-6.2% [p<0.001], respectively). Interestingly, there was a significantly smaller amount of 24-h urinary calcium in the Maxmarvil group (p<0.05).

CONCLUSIONS: Our study demonstrates that a combination of calcitriol and alendronate is quite effective in preventing bone loss, with the advantage of lesser hypercalciuric effect of calcitriol in the postmenopausal osteoporotic women.
MeSH terms
Alendronate/adverse effectsAlendronate/therapeutic use*Alkaline Phosphatase/bloodBiological Markers/analysisBone Density/physiologyBone Density Conservation Agents/adverse effectsBone Density Conservation Agents/therapeutic use*Calcitriol/adverse effectsCalcitriol/therapeutic use*Collagen Type I/urineDouble-Blind MethodDrug CombinationsFemaleFemur/metabolismHumansHydroxycholecalciferols/adverse effectsHydroxycholecalciferols/therapeutic useKorea/epidemiologyLumbar Vertebrae/metabolismMiddle AgedOsteoporosis, Postmenopausal/drug therapy*Osteoporosis, Postmenopausal/epidemiologyOsteoporosis, Postmenopausal/metabolismPeptides/urineTreatment Outcome
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
AJOU Authors
정, 윤석김, 대중
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