Chapuy calcium and vitamin D

Vitamin D3 and calcium to prevent hip fractures in elderly women

Chapuy MC, Arlot ME, Duboeuf F, et al. The New England journal of medicine 1992 · PMID 1331788 · doi:10.1056/nejm199212033272305

Question

Does daily calcium and vitamin D3 supplementation reduce hip fractures in frail elderly women?

Design

Double-blind placebo-controlled RCT in French nursing homes and residential care.

Patients

Ambulatory elderly women living in residential care in France, many with vitamin D insufficiency.

Intervention

Calcium 1.2 g plus vitamin D3 800 IU daily

Comparison

Double placebo

Primary outcome

Hip and other non-vertebral fractures at 18 months

Key result

Supplementation significantly reduced hip fractures and other non-vertebral fractures, with correction of secondary hyperparathyroidism.

Limitations

Highly selected, institutionalised and vitamin D-deficient population; benefits have not been replicated in community-dwelling, vitamin D-replete adults.

Impact on practice

Supports calcium and vitamin D replacement in deficient, housebound or institutionalised older people and as an adjunct to antiresorptive therapy.