Alfacalcidol in the treatment of patients with osteoporosis in modern clinical practice
Nikitinskaya O.A., Dobrovolskaya O.V., Toroptsova N.V.

Research Institute of Rheumatology named after V.A. Nasonova, Moscow

Active metabolites of vitamin D have proven in numerous clinical studies their effectiveness and safety in the treatment of patients with osteoporosis (OP).
Aim. The present study was to define the place of alfacalcidol, one of the representatives of this class of drugs in the treatment of patients with OP in current clinical practice on the basis of a survey of doctors and patients.
Patients and methods. The first part of the work consisted of a survey of 307 doctors of 6 basic specialties dealing with the OP problem. The questionnaires included questions about the frequency and the number of consulted OP patients, the methods of diagnosis and treatment.
The second part of the survey involved 1799 patients aged from 25 to 92 years. The compliance to antiosteoporotic ongoing therapy was evaluated over the last 12 months before the survey according to the following parameters: duration, no pass receptions, the implementation of guidelines for the use of the drug.
The third part of the work included a prospective 3-year monitoring of 196 postmenopausal women who have had OP-fractures of different localization. Using questionnaires we evaluated the effectiveness of antiosteoporotic treatment and compliance to it.
Results. Our study showed that doctors recommended alfacalcidol to 27% of patients, in 8% of cases as a monotherapy. Among the patients, 25% of respondents took this drug in combination with other drugs for the treatment of OP (22%) and in monotherapy (3%). Among those who have had the OP-fracture, compliance to treatment with alfacalcidol over 36 months was 50% for monotherapy, and 21% for a  combination therapy.
Conclusions. The surveys of physicians and patients with OP and OP-fractures demonstrated that alfacalcidol, having an optimal safety profile, in clinical practice is widely used for mono- and combination therapy of OP. Perspectives of its use were expanded in connection with the possibility of transfering the patients with bisphosphonates treatment on an alternative alfacalcidol therapy during "drug holidays".

Key words: osteoporosis, antiosteoporotic treatment, compliance, alfacalcidol
For citation: Nikitinskaya O.A., Dobrovolskaya O.V., Toroptsova N.V. Alfacalcidol in the treatment of patients with osteoporosis in modern clinical practice // RMJ. 2017. № 7. P.452 –456.