Tottori University, School of Health Science, 86 Nishi-Cho, Yonago, Tottori 683-8503, Japan.
Expert Opin Pharmacother. 2013 Apr;14(6):817-25. doi: 10.1517/14656566.2013.778825. Epub 2013 Mar 11.
Eldecalcitol is an active vitamin D(3) analog, characterized by high stability in the circulation and also in the peripheral tissues, and by strong activity in increasing bone mass in osteoporotic patients. The objective of the present review was to evaluate the effect of eldecalcitol on bone compared with active vitamin D or placebo in preclinical and clinical studies.
Eldecalcitol increased bone mineral density and reduced bone turnover markers greater than alfacalcidol and placebo. Interestingly, in a 3-year clinical trial, bone resorption marker remained suppressed during the eldecalcitol treatment, whereas bone formation markers gradually recovered after initial suppression. The incidences of vertebral fractures and wrist fractures in eldecalcitol-treated group were significantly lower than those in alfacalcidol-treated group by 26 and 71%, respectively. In the patients whose baseline bone turnover was low, eldecalcitol treatment did not further suppress bone turnover markers during the 3-year treatment period.
Eldecalcitol reduced wrist fractures much greater than alfacalcidol and one of the reasons may be a stronger effect of eldecalcitol on preventing falls. Although the effect of eldecalcitol on bone turnover markers was stronger than that of alfacalcidol or placebo, eldecalcitol is not a mere antibone resorptive agent, rather act as a bone turnover modulator.
艾地骨化醇是一种活性维生素 D（3）类似物，具有在血液循环中和外周组织中高度稳定的特点，并具有增加骨质疏松症患者骨量的强大活性。本综述的目的是评估艾地骨化醇与活性维生素 D 或安慰剂在临床前和临床研究中对骨骼的影响。
艾地骨化醇增加骨矿物质密度并降低骨转换标志物的作用大于阿尔法骨化醇和安慰剂。有趣的是，在一项为期 3 年的临床试验中，骨吸收标志物在艾地骨化醇治疗期间仍受到抑制，而骨形成标志物在初始抑制后逐渐恢复。艾地骨化醇治疗组的椎体骨折和腕骨骨折发生率分别比阿尔法骨化醇治疗组低 26%和 71%。在基线骨转换率较低的患者中，艾地骨化醇治疗在 3 年治疗期间不会进一步抑制骨转换标志物。
艾地骨化醇降低腕骨骨折的效果远大于阿尔法骨化醇，其原因之一可能是艾地骨化醇在预防跌倒方面的作用更强。尽管艾地骨化醇对骨转换标志物的作用强于阿尔法骨化醇或安慰剂，但它不是单纯的抗骨吸收剂，而是一种骨转换调节剂。
