Alendronato de sódio e vitamina D na osteoporose pós-menopausa

Revisão sistemática

Autores

DOI:

https://doi.org/10.15448/1980-6108.2022.1.42267

Palavras-chave:

osteoporose, pós-menopausa, alendronato, vitamina D, recuperação óssea

Resumo

Objetivo: avaliar a eficácia da utilização da terapia combinada de alendronato de sódio e vitamina D no metabolismo ósseo de mulheres em tratamento de osteoporose pós-menopausa.
Métodos: trata-se de uma revisão sistemática, a qual foram pesquisados ensaios clínicos randomizados (ECR) indexados nas bases de dados BVS, ISI Web of Science, PubMed, SciELO, ScienceDirect e Scopus que comparavam a associação de alendronato sódico e vitamina D com a monoterapia de alendronato de sódio. 
Resultados: um total de seis ECR contemplou os critérios para serem inclusos nesse estudo, compreendendo um total de 4164 participantes e seus respectivos dados. Os estudos avaliaram diferentes domínios do metabolismo ósseo, como níveis séricos de vitamina D, paratormônio, densidade mineral óssea e marcadores de turnover ósseo. A terapia combinada produziu melhora significativa nos marcadores metabólicos ósseos. 
Conclusão: a terapia combinada de alendronato de sódio com vitamina D promove melhora no metabolismo ósseo de mulheres com osteoporose pós-menopausa.

Downloads

Não há dados estatísticos.

Biografia do Autor

José Reginaldo Alves de Queiroz Júnior, Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Recife, PE, Brasil.

Graduando em Medicina pela Universidade Federal de Pernambuco (UFPE), em Recife, PE, Brasil.

Jarson Pedro da Costa Pereira, Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Recife, PE, Brasil.

Mestrando em Nutrição e Saúde Pública pela Universidade Federal de Pernambuco (UFPE), em Recife, PE, Brasil.

Leonardo Lucas Pires, Universidade Potiguar (UnP), Departamento de Ciências Médicas, Natal, RN, Brasil.

Graduando em Medicina pela Universidade Potiguar (UnP), em Natal, RN, Brasil. 

Carina Scanoni Maia, Universidade Federal de Pernambuco (UFPE), Departamento de Histologia e Embriologia, Recife, PE, Brasil.

Doutora em Biociência Animal pela Universidade Federal Rural de Pernambuco (UFRPE), em Recife, PE, Brasil; Professora da Universidade Federal de Pernambuco (UFPE), em Recife, PE, Brasil.

Referências

Radominski SC, Bernardo W, Paula AP, Albergaria B, Moreira C, Fernandes CE, et al. Diretrizes brasileiras para o diagnóstico e tratamento da osteoporose em mulheres na pós-‐menopausa. Rev Bras Reumatol. 2017;57:452-66. https://doi.org/10.1016/j.rbre.2017.07.001

Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s guide to prevention and treatmentof osteoporosis. Osteoporos Int. 2014;25:2359. https://doi.org/10.1007/s00198-014-2794-2

NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001; 285:785-95. https://doi.org/10.1001/jama.285.6.785

Lazaretti-Castro M, Eis SR, Marques Neto JF. A prevenção da osteoporose levada a sério: uma necessidade nacional. Arq Bras Endrocrinol Metab. 2008;52(4):712-3. https://doi.org/10.1590/S0004-27302008000400020

Mabey T, Honsawek S. Role of Vitamin D in osteoarthritis: molecular, cellular, and clinical perspectives. Int J Endocrinol. 2015;2015:1-14. https://doi.org/10.1155/2015/383918

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-81. https://doi.org/10.1056/NEJMra070553

Narula K, Tauseef M, Ahmad I, Agarwal K, Ashok A, Anjana A. Vitamin D deficiency among postmenopausal women with osteoporosis. J Clin Diagn Res. 2013;7:336-8. https://doi.org/10.7860/JCDR/2013/5022.2761

Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing. 2000;29:301-4. https://doi.org/10.1093/ageing/29.4.301

Rosen CJ. The Epidemiology and pathogenesis of osteoporosis [Updated 2014 Jan 10]. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext South Dartmouth (MA): MDText com, Inc. 2014; 2000: Available from: https://www.ncbi.nlm.nih.gov/books/NBK279134.

Agnusdei D, Crepaldi G, Isaia G, et al. A double blind, placebo-controlled trial of ipriflavone for prevention of postmenopausal spinal bone loss. Calcif Tissue Int. 1997;61(2):142-147. https://doi.org/10.1007/s002239900312

Kocijan R, Klaushofer K, Misof BM. Osteoporosis therapeutics 2020, Berlin, Heidelberg: Springer Berlin Heidelberg; 2020.

Shane E. Evolving data about subtrochanteric fractures and bisphosphonates. N Engl J Med. 2010;362(19):1761-71. https://doi.org/10.1056/NEJMe1003064

Saag K, Lindsay R, Kriegman A, Beamer E, Zhou W. A single zoledronic acid infusion reduces bone resorption markers more rapidly than weekly oral alendronate in postmenopausal women with low bone mineral density. Bone. 2007;40(5): 1238-43. https://doi.org/10.1016/j.bone.2007.01.016

Higgins JP, Thomas J, Chandler J et al., editors. Cochrane handbook for systematic reviews of interventions. Chichester (UK): John Wiley & Sons; 2019.

Roux C, Binkley N, Boonen S, et al. Vitamin D status and bone mineral density changes during alendronate treatment in postmenopausal osteoporosis. Calcif Tissue Int. 2014;94(2):153-7. https://doi.org/10.1007/s00223-013-9763-1

Kim KJ, Min YK, Koh JM, et al. Efficacy and safety of weekly alendronate plus vitamin D₃ 5600 IU versus weekly alendronate alone in korean osteoporotic women: 16-week randomized trial. Yonsei Med J. 2014;55(3):715-24. https://doi.org/10.3349/ymj.2014.55.3.715

Olmos JM, Hernández JL, Llorca J, et al. Effects of 25-hydroxyvitamin D3 therapy on bone turnover markers and PTH levels in postmenopausal osteoporotic women treated with alendronate. J Clin Endocrinol Metab. 2012;97(12):4491–7. https://doi.org/10.1210/jc.2012-2999

Orimo H, Nakamura T, Fukunaga M, et al. 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):1273-84. https://doi.org/10.1185/03007995.2011.580341

Binkley N, Ringe JD, Reed JI, Ljunggren O, Holick MF, Minne HW, Liu M, Lamotta A, West JA, Santora AC. Alendronate/vitamin D3 70 mg/2800 IU with and without additional 2800 IU vitamin D3 for osteoporosis: results from the 24-week extension of a 15-week randomized, controlled trial. Bone. 2009;44(4):639-47. https://doi.org/10.1016/j.bone.2008.05.002

Recker R, Lips P, Felsenberg D, et al. Alendronate with and without cholecalciferol for osteoporosis: results of a 15-week randomized controlled trial. Curr Med Res Opin. 2006;22(9):1745-55. https://doi.org/10.1185/030079906x120913

Mata PR, Martins PA, Brito LG, Ramos MMP, Santos Junior, MC. Tratamento farmacológico para a osteoporose. Geriatrics, Gerontology and Aging. 2012;6(4):422–31.

Benjamin B, Benjamin MA, Swe M, Sugathan S. Review on the comparison of effectiveness between denosumab and bisphosphonates in post-menopausal osteoporosis. Osteoporosis and Sarcopenia. 2016;2:77-81. https://doi.org/10.1016/j.afos.2016.03.003

Drieling RL, LaCroix AZ, Beresford SAA, Boudreau DM, Kooperberg C, Chlebowski RT, et al. Long-Term oral bisphosphonate therapy and fractures in older women: the women’s health initiative. J Am Geriatr Soc. 2017;65:1924-31. https://doi.org/10.1111/jgs.14911

Yeaw J, Benner JS, Walt JG, Sian S, Smith DB. Comparing adherence and persistence across 6 chronic medication classes. JMCP. 2009;15:728-40. https://doi.org/10.18553/jmcp.2009.15.9.728

Barrett-Connor E, Wade SW, Do TP, Satram-Hoang S, Stewart R, Gao G, et al. Treatment satisfaction and persistence among postmenopausal women on osteoporosis medications: 12-month results from POSSIBLE USTM. Osteoporos Int. 2012;23:733-41. https://doi.org/10.1007/s00198-011-1620-3

Leib ES, Lewiecki EM, Binkley N, Hamdy RC. Official positions of the international society for clinical densitometry. J Clin Densitom. 2004;7:1-6. https://doi.org/10.1385/JCD:7:1:1

Eastell R, Szulc P. Use of bone turnover markers in postmenopausal osteoporosis. The Lancet Diabetes & Endocrinology. 2017;5:908-23. https://doi.org/10.1016/S2213-8587(17)30184-5

Vasikaran SD. Bisphosphonates: an overview with special reference to alendronate. Ann Clin Biochem. 2001;38(6):608-623. https://doi.org/10.1258/0004563011901037

Horwitz MJ, Tedesco MB, Sereika SM, Syed MA, Garcia-Ocaña A, Bisello A, et al. Continuous PTH and PTHrP infusion causes suppression of bone formation and discordant effects on 1,25(OH)2 vitamin D. J Bone Miner Res. 2005;20:1792-1803. https://doi.org/10.1359/JBMR.050602

Cândido F, Bressan J. Vitamin D: Link between Osteoporosis, obesity, and diabetes? IJMS. 2014;15:6569-91. https://doi.org/0.3390/ijms15046569

Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257. https://doi.org/10.1001/jama.293.18.2257

Downloads

Publicado

2022-08-25

Como Citar

Júnior, J. R. A. de Q., Pereira, J. P. da C., Pires, L. L., & Maia, C. S. (2022). Alendronato de sódio e vitamina D na osteoporose pós-menopausa: Revisão sistemática. Scientia Medica, 32(1), e42267. https://doi.org/10.15448/1980-6108.2022.1.42267

Edição

Seção

Revisão Sistemática e Metanálise