Efficacy of two calcifediol supplementation regimens in older adults post-hip fracture surgery. A clinical trial.

BACKGROUND

Vitamin D deficiency is highly prevalent among older adults with hip fracture and may compromise recovery. This study evaluated the effectiveness of two calcifediol supplementation regimens in correcting serum 25-hydroxyvitamin D [25(OH)D] levels and supporting functional recovery.

METHODS

In this randomized clinical trial, 50 patients aged ≥ 75 years with hip fracture and serum 25(OH)D < 30 ng/mL were assigned to receive calcifediol 266 μg daily for 5 days (intervention group, IG) or 266 μg weekly for 5 weeks (control group, CG). Primary endpoints were the proportion achieving 25(OH)D > 30 ng/mL, change in parathyroid hormone, and functional recovery assessed at discharge and at 3, 6, and 12 months post-fracture.

RESULTS

The mean age was 86 years; 64% were women. Baseline 25(OH)D was 13.3 ng/mL in the IG and 12.0 ng/mL in the CG. After one month, both groups showed increased concentrations (38.2 vs. 35.2 ng/mL; p = 0.50). PTH decreased more in the IG (43.5 vs. 75.2 pg/mL; p = 0.001). Approximately 50% of patients showed clinically meaningful functional improvement. Multivariate analysis indicated lower relative functional gain in CG participants who did not achieve optimal 25(OH)D levels (67.2 vs. 43.7; p = 0.06). No significant differences in long-term functional outcomes were observed between groups.

CONCLUSIONS

Both daily and weekly calcifediol regimens effectively corrected vitamin D deficiency in older adults with hip fracture. Functional improvement at discharge was observed in both groups and was clinically relevant.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03213886 (Date of registration: 11/07/2017).