TREATMENT OF POST MENOPAUSAL OSTEOPOROSIS. A CONTROLLED THERAPEUTIC TRIAL COMPARING OESTROGEN/GESTAGEN, 1,25‐DIHYDROXY‐VITAMIN D3 AND CALCIUM

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Abstract
A controlled therapeutic trial on seventy-four 70 yr old women was carried out with the purpose of finding the optimal treatment for post menopausal osteoporosis. The bone mineral content (BMC) was measured by 125I-photonabsorptiometry at 2 sites in the distal part of the forearms, where the trabecular/cortical ratio is 0.25 and 1.5, respectively. Radiographs were done on the right hand to measure the metacarpal bone mass (cortical area/total area = CA/TA). After observing the spontaneous course of bone loss for 6 mo., the 1,25-dihydroxycholecalciferol [1,25(OH)2D3] and estrogen/gestagen, alone or in combination, and Ca. The groups treated with estrogen/gestagen [with or without 1,25(OH)2D3] showed a highly significant increase in BMC. In contrast bone mineral remained unchanged or decreased in both the Ca and the 1,25(OH)2D3 groups with a tendency towards more pronounced negative bone balance in the 1,25-(OH)2D3 group. Seven out of 19 patients on 1,25(OH)2D3 developed hypercalcemia, which necessitated a reduction in dosage. The new vitamin D metabolite, 1,25(OH)2D3, given in clinically acceptable doses, apparently is without value in the treatment of post menopausal osteoporosis.