Calcium Combine With Active Vitamin D For The Prevention And Treatment In Patient With Glucocorticoid-Induced Osteoporosis: A Systematic Review

OBJECTIVE To assess the efficacy and safety of calcium comb-ine with active vitamin D on bone mineral density (BMD)and fractures in patient with glucocorticiod-induced osteoporosis.METHODS We searched MEDLINE(1966to March 2009), EMB-ASE(1974 to March 2009), The Cochrane Library, CBM(1983-2009,3), CMKI(1994-2009,3). Some related journals were handsearched as we-ll.The quality of included randomized controlled trials (RCTs)was eva-luated and meta-analysis was conducted by The Cochrane Collaboration, s software RevMan5.0.RESULTS Five studies involving 360patients were included. Five studies have no the datas of BMD,so Meta-analysis can not be conduct-ed,we only use the describe-analysis.Only two studies report the datas of fractures, the result of Meta-analysis showed that Calcium+active vitamin D in reducing the rate of fracture was not superior to the control group[RR=0.63, 95%CI(0.2, 1.98), P=0.43]. there was higher risk of hypercalcemia in Calcium+active vitamin D group than control group [RR=7.18, 95%CI(2.22, 23.26), P=0.001].CONCLUSION Calcium+active vitamin D in reducing the bone loss is/not better than calcium alone,this review is not yet a clear answer.But calcium+active vitamin D in reducing the rate of fracture was not superior to calcium alone or calcium+non-active vitaminD, and there was higher risk of hypercalcemia in Calcium+active vitamin D group ,so when we use Calcium+active vitamin D ,we should monitor serum calcium.