OBJECTIVE: To assess whether supplementation with calcium and cholecaliferol (vitamin D3) reduces the risk of fracture in women with one or more risk factors for fracture of the hip. DESIGN: Pragmatic open randomised controlled trial. SETTING:Practice nurse led clinics in primary care. PARTICIPANTS: 3314 women aged 70 and over with one or more risk factors for hip fracture: any previous fracture, low body weight (< 58 kg), smoker, family history of hip fracture, or fair or poor self reported health. INTERVENTION: Daily oral supplementation using 1000 mg calcium with 800 IU cholecaliferol and information leaflet on dietary calcium intake and prevention of falls, or leaflet only (control group). MAIN OUTCOME MEASURES: Primary outcome measure was all clinical fractures and secondary outcome measures were adherence to treatment, falls, and quality of life (measured with the SF-12). RESULTS: 69% of the women who completed the follow-up questionnaire at 24 months were still taking supplements (55% with inclusion of randomised participants known to be alive). After a median follow-up of 25 months (range 18 to 42 months), clinical fracture rates were lower than expected in both groups but did not significantly differ for all clinical fractures (odds ratio for fracture in supplemented group 1.01, 95% confidence interval 0.71 to 1.43). The odds ratio for hip fracture was 0.75 (0.31 to 1.78). The odds of a woman having a fall at six and 12 months was 0.99 and 0.98, respectively. Quality of life did not significantly differ between the groups. CONCLUSION: We found no evidence that calcium and vitamin D supplementation reduces the risk of clinical fractures in women with one or more risk factors for hip fracture. Registration ISRCTN26118436, controlled trials registry.
RCT Entities:
OBJECTIVE: To assess whether supplementation with calcium and cholecaliferol (vitamin D3) reduces the risk of fracture in women with one or more risk factors for fracture of the hip. DESIGN: Pragmatic open randomised controlled trial. SETTING: Practice nurse led clinics in primary care. PARTICIPANTS: 3314 women aged 70 and over with one or more risk factors for hip fracture: any previous fracture, low body weight (< 58 kg), smoker, family history of hip fracture, or fair or poor self reported health. INTERVENTION: Daily oral supplementation using 1000 mg calcium with 800 IU cholecaliferol and information leaflet on dietary calcium intake and prevention of falls, or leaflet only (control group). MAIN OUTCOME MEASURES: Primary outcome measure was all clinical fractures and secondary outcome measures were adherence to treatment, falls, and quality of life (measured with the SF-12). RESULTS: 69% of the women who completed the follow-up questionnaire at 24 months were still taking supplements (55% with inclusion of randomised participants known to be alive). After a median follow-up of 25 months (range 18 to 42 months), clinical fracture rates were lower than expected in both groups but did not significantly differ for all clinical fractures (odds ratio for fracture in supplemented group 1.01, 95% confidence interval 0.71 to 1.43). The odds ratio for hip fracture was 0.75 (0.31 to 1.78). The odds of a woman having a fall at six and 12 months was 0.99 and 0.98, respectively. Quality of life did not significantly differ between the groups. CONCLUSION: We found no evidence that calcium and vitamin D supplementation reduces the risk of clinical fractures in women with one or more risk factors for hip fracture. Registration ISRCTN26118436, controlled trials registry.
Authors: Haakon E Meyer; Guro B Smedshaug; Elisabeth Kvaavik; Jan A Falch; Aage Tverdal; Jan I Pedersen Journal: J Bone Miner Res Date: 2002-04 Impact factor: 6.741
Authors: M C Chapuy; R Pamphile; E Paris; C Kempf; M Schlichting; S Arnaud; P Garnero; P J Meunier Journal: Osteoporos Int Date: 2002-03 Impact factor: 4.507
Authors: Heike A Bischoff-Ferrari; Bess Dawson-Hughes; Walter C Willett; Hannes B Staehelin; Marlet G Bazemore; Robert Y Zee; John B Wong Journal: JAMA Date: 2004-04-28 Impact factor: 56.272
Authors: David A Hanley; Ann Cranney; Glenville Jones; Susan J Whiting; William D Leslie; David E C Cole; Stephanie A Atkinson; Robert G Josse; Sidney Feldman; Gregory A Kline; Cheryl Rosen Journal: CMAJ Date: 2010-07-12 Impact factor: 8.262
Authors: Nelson B Watts; John P Bilezikian; Pauline M Camacho; Susan L Greenspan; Steven T Harris; Stephen F Hodgson; Michael Kleerekoper; Marjorie M Luckey; Michael R McClung; Rachel Pessah Pollack; Steven M Petak Journal: Endocr Pract Date: 2010 Nov-Dec Impact factor: 3.443
Authors: Clifford J Rosen; John S Adams; Daniel D Bikle; Dennis M Black; Marie B Demay; JoAnn E Manson; M Hassan Murad; Christopher S Kovacs Journal: Endocr Rev Date: 2012-05-17 Impact factor: 19.871