Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men.

Study answer

What this study found

Vitamin D alone did not prevent fractures: hip fracture RR 1.12 (95% CI 0.98 to 1.29), non-vertebral fracture RR 1.05 (0.96 to 1.14), vertebral fracture RR 1.03 (0.76 to 1.39), and any new fracture RR 1.03 (0.96 to 1.11). Vitamin D plus calcium modestly reduced hip fractures (RR 0.84, 0.74 to 0.96) and any fracture (RR 0.95, 0.90 to 0.99), with stronger effects in institutional residents for hip fracture (RR 0.75, 0.62 to 0.92). Alfacalcidol reduced vertebral fractures (RR 0.57, 0.49 to 0.65) but not hip or non-vertebral fractures, whereas calcitriol did not show consistent fracture benefit.…

Study & population

Systematic review and meta-analysis of randomized and quasi-randomized trials in post-menopausal women and older men, mostly aged over 65 years, recruited from community, nursing home, assisted living, hospital, and long-stay geriatric settings.

Intervention

The review evaluated oral and occasional intramuscular vitamin D2 or D3, often with calcium co-supplementation, and the active vitamin D analogues alfacalcidol and calcitriol.

Key limitation

The evidence base was heterogeneous in population, formulation, dose, route, and duration, and several trials were small or had incomplete follow-up.

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Original abstract