Efficacy of Vitamin K2 for Glucocorticoid-induced Osteoporosis in Patients with Systemic Autoimmune Diseases

Intern Med. 2016;55(15):1997-2003. doi: 10.2169/internalmedicine.55.6230. Epub 2016 Aug 1.

Abstract

Objective Vitamin K2 (menatetrenone) is an effective treatment for patients with postmenopausal osteoporosis. We herein performed a subanalysis of patients with systemic autoimmune diseases undergoing glucocorticoid therapy in our previous prospective study. Methods Sixty patients were categorized into a group with vitamin K2 treatment (n=20, Group A) and a group without vitamin K2 treatment (n=40, Group B). All patients were treated with bisphosphonates. Results Serum levels of osteocalcin and undercarboxylated osteocalcin decreased significantly after the start of glucocorticoid therapy in both groups, while the serum osteocalcin level was significantly higher in Group A than Group B during the third (p=0.0250) and fourth weeks (p=0.0155). The serum level of the N-terminal peptide of type I procollagen, a bone formation marker, decreased during glucocorticoid therapy, but was significantly higher in Group A than Group B during the fourth week (p=0.0400). The bone mineral density and fracture rate showed no significant differences between the two groups. Conclusion Although vitamin K2 improves bone turnover markers in patients with osteoporosis on glucocorticoid therapy, it has no significant effect on the bone mineral density and fracture rate after 1.5 years of treatment.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Autoimmune Diseases / drug therapy*
  • Biomarkers
  • Bone Density / drug effects
  • Collagen Type I / blood
  • Diphosphonates / therapeutic use
  • Female
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / drug therapy*
  • Osteoporosis / etiology*
  • Prospective Studies
  • Vitamin K 2 / analogs & derivatives*
  • Vitamin K 2 / therapeutic use

Substances

  • Biomarkers
  • Collagen Type I
  • Diphosphonates
  • Glucocorticoids
  • Vitamin K 2
  • menatetrenone