The Never-Ending Uncertainty of Antifracture Efficacy of Calcium Supplementation?
Three studies have examined the effect of calcium supplementation on fracture incidence.[15,16,17] Compliance with medication was poor in all trials and, by intention to treat, no reduction in fracture risk was observed. Methodologic problems, such as subjects being calcium replete, make any inferences problematic. Moreover, although a benefit in reduction of fracture risk was reported in patients who were compliant with calcium supplementation, loss of randomization leaves the possibility that the fewer fractures in the calcium-treated group may be the result of factors other than the calcium supplement.
At this meeting, Bischoff-Ferrari and colleagues reported results from a double-blind, randomized controlled trial (RCT) of 930 participants (72% male, mean age 61 years) who were randomly assigned to 4 years of 1.2 g calcium vs placebo and then followed for a mean of 10.3 years. Fractures occurred in 46/464 in the calcium-treated group and 54/466 in the placebo-treated group (HR 0.87; 0.58-1.28). Although fracture rates were not significantly different between groups, minimal trauma fracture rates were: 15/464 in the calcium-treated group vs 29/466 in the placebo-treated (HR 0.52, 0.28-0.97; P = .04). This is one of the first studies demonstrating a benefit of calcium supplements in fracture risk reduction, and publication of these data is awaited with interest.
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Cite this: Highlights of the 28th Annual Meeting of the American Society for Bone and Mineral Research (ASBMR) - Medscape - Jan 10, 2007.