COMPARISON OF THE EFFICACY OF 2 INJECTABLE FORMS OF VITAMIN-D-3 AND ORAL ONE-ALPHA IN TREATMENT OF SECONDARY HYPERPARATHYROIDISM IN PATIENTS ON MAINTENANCE HEMODIALYSIS
K. Elreshaid et al., COMPARISON OF THE EFFICACY OF 2 INJECTABLE FORMS OF VITAMIN-D-3 AND ORAL ONE-ALPHA IN TREATMENT OF SECONDARY HYPERPARATHYROIDISM IN PATIENTS ON MAINTENANCE HEMODIALYSIS, American journal of nephrology, 17(6), 1997, pp. 505-510
In the present study, we compared the efficacy of two intravenous form
s of vitamin D-3 [Calcijex: 1,25(OH)(2)D-3 and One-Alpha: 1(OK)D-3] an
d that of oral One-Alpha in the treatment of secondary hyperparathyroi
dism in patients receiving maintenance hemodialysis. Twenty patients w
ere assigned to 1 of 2 treatment groups (A and B) which were matched f
or age, sex, and duration of maintenance hemodialysis. None of the pat
ients included had chronic liver disease or had received drugs known t
o interfere with hepatic enzymes. All patients had received a stable d
ose of oral calcium and One-Alpha for a minimum period of 1 year, whic
h maintained corrected serum calcium at the upper limit of the normal
range. At the start of the study, oral One-Alpha was replaced by Calci
jex in group A and injectable One-Alpha in group B. Treatment was main
tained for 3 months (phase I). Subsequently, injectable vitamin D-3 wa
s discontinued and all patients received their previous dose of oral O
ne-Alpha for a period of I month. Finally, oral One-Alpha was disconti
nued again and the injectable forms of vitamin D-3 were crossed over i
n the 2 treatment groups for another 3 months (phase II). The results
showed that the serum concentrations of 1,25(OH)(2)D-3, measured 48 h
after intravenous injection of One-Alpha, were not different from that
produced by an equivalent dose of Calcijex in the same group of patie
nts. Furthermore, overall analysis of intact parathyroid levels during
the cross-over, using ANOVA with repeated responses, indicated that t
he two analogues were equipotent as regards suppression of PTH secreti
on. In our study, treatment with intravenous vitamin D-3 led to signif
icant suppression of PTH secretion. These results were achieved by a l
ower drug dosage of vitamin D-3 and at lower trough blood levels of 1,
25(OK)(2)D-3 as compared to those of oral One-Alpha. Our findings are
in favor of the early use of either forms of injectable vitamin D-3 in
the treatment of secondary hyperparathyroidism.