A Pooled Analysis of Vitamin D Dose Requirements for Fracture Prevention

H.A. Bischoff-Ferrari, W.C. Willett, E.J. Orav, P. Lips, P.J. Meunier, R.A. Lyons, Leon Flicker, J. Wark, R.D. Jackson, J.A. Cauley, H.E. Meyer, M. Pfeifer, K.M. Sanders, H.B. Stähelin, R. Theiler, B. Dawson-Hughes

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    Abstract

    [Truncated abstract] Approximately 75% of fractures occur in people 65 years of age or older.1 By 2050, the worldwide incidence of hip fractures is expected to increase by 240% among women and 310% among men.2 One strategy to prevent fractures in this population might be universal vitamin D supplementation. However, the results of several study level meta-analyses and one pooled participant-level analysis do not agree. Although one trial-level meta-analysis of double-blind, randomized, controlled trials suggested an 18% reduction in the incidence of hip fracture and a 20% reduction in the incidence of any nonvertebral fracture at a received dose of no less than 482 IU of vitamin D per day,3 three study-level meta-analyses4-6 and one pooled analysis of participant-level data7 from open-design and blinded trials suggested that vitamin D may have no effect on total fractures4 or may reduce hip fracture by 7 to 16%, if combined with calcium supplementation, regardless of the dose of vitamin D.4-7 The discordant findings may be explained, in part, by differences in the criteria for including trials in the analyses, with respect to blinding, vitamin D formulation (oral vs. injectable), or accommodations for nonadherence....
    Original languageEnglish
    Pages (from-to)40-49
    JournalNew England Journal of Medicine
    Volume367
    DOIs
    Publication statusPublished - 5 Jul 2012

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    Bischoff-Ferrari, H. A., Willett, W. C., Orav, E. J., Lips, P., Meunier, P. J., Lyons, R. A., Flicker, L., Wark, J., Jackson, R. D., Cauley, J. A., Meyer, H. E., Pfeifer, M., Sanders, K. M., Stähelin, H. B., Theiler, R., & Dawson-Hughes, B. (2012). A Pooled Analysis of Vitamin D Dose Requirements for Fracture Prevention. New England Journal of Medicine, 367, 40-49. https://doi.org/10.1056/NEJMoa1109617