Vitamin D modulates bisphosphonate (BP) efficacy, but its contribution to bone mineral density (BMD) after BP discontinuation is not known. To address this topic, we performed a retrospective analysis of postmenopausal women exposed to alendronate (ALN) to treat osteoporosis who regularly continued the supplementation of cholecalciferol or calcifediol at recommended doses. In the ninety-six recruited women (age 61.1 ± 6.9 years), ALN was administered for 31.2 ± 20.6 months and then discontinued for 33.3 ± 18.9 months. The modification of 25(OH)D serum levels over time was associated with a change of alkaline phosphatase (r = -0.22, = 0.018) and C-terminal collagen type 1 telopeptide (r = -0.3, = 0.06). Women in the tertile of the highest increase in 25(OH)D level showed a 5.7% BMD gain at lumbar spine, that was twice as great in comparison with participants with a lower 25(OH)D variation. At a multiple regression analysis, BMD change was associated with time since menopause (ß = 2.28, SE 0.44, < 0.0001), FRAX score for major fracture (ß = -0.65, SE 0.29, = 0.03), drug holiday duration (ß = -2.17, SE 0.27, < 0.0001) and change of 25(OH)D levels (ß = 0.15, SE 0.03, = 0.0007). After ALN discontinuation, improving the vitamin D status boosts the ALN tail effect on BMD.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226654PMC
http://dx.doi.org/10.3390/nu13061878DOI Listing

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