Overcoming resistance to bisphosphonates through the administration of alfacalcidol: Results of a 1-year, open follow-up study

János Gaál, Tamás Bender, József Varga, Irén Horváth, Judit Kiss, Péter Somogyi, Péter Surányi

Research output: Article

7 Citations (Scopus)


This study intended to determine whether the replacement of vitamin D3 with alfacalcidol results in any bone mineral density (BMD) increase in 76 patients unresponsive to the combination of alendronate and conventional vitamin D3 treatment. In these patients the conventional vitamin D3 had been replaced with alfacalcidol (0.5 μg/day), and then the patients were followed up for a year. After treatment for 1 year, Wilcoxon test revealed a small but statistically significant (P < 0.001) increase in the BMD values of the forearm and lumbar vertebrae, in the serum calcium and urinary calcium/creatinine ratio in first-voided morning urine. However, the serum alkaline phosphatase activity, phosphorus, parathormone, osteocalcin levels and the urinary d-pyr/creatinine ratio decreased significantly (P < 0.001). As suggested by our results, combination therapy with alendronate and alfacalcidol increases bone density and improves the biochemical markers of bone turnover, without any substantial increase in the incidence of adverse effects.

Original languageEnglish
Pages (from-to)25-31
Number of pages7
JournalRheumatology International
Issue number1
Publication statusPublished - nov. 1 2009


ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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