Evidence map›Paper›PMID 39264438›Full record

Trial reportOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024

Changes in bone density and microarchitecture following treatment of Graves' disease and the effects of vitamin D supplementation. A randomized clinical trial.

Diana Grove-Laugesen, Eva Ebbehoj, Torquil Watt, Klavs Würgler Hansen, Lars Rejnmark

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02384668 (The DAGMAR Study. D-vitamin And Graves' Disease; Morbidity And Relapse Reduction), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02384668 nacompletednot on this map

The DAGMAR Study. D-vitamin And Graves' Disease; Morbidity And Relapse Reduction: A Randomised, Clinical Trial.

TypeinterventionalSponsorUniversity of AarhusRan2015 to 2020Enrolled278ConditionsGraves' DiseaseArmsCholecalciferol, Placebo
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. TheInternational journal of burns and trauma · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Diana Grove-LaugesenDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. dianagrove@clin.au.dk.ORCID http://orcid.org/0000-0002-9681-7394
Eva EbbehojDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Torquil WattDepartment of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark.
Klavs Würgler HansenDiagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark.
Lars RejnmarkDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Thyrotoxicosis leads to loss of bone mass. Vitamin D is important to bone health. In this randomized, placebo-controlled trial, we showed that bone restoration did not improve when adding vitamin D supplementation to standard care of Graves' disease thyrotoxicosis. Bone density and microarchitecture improved markedly with treatment of thyrotoxicosis. PURPOSE: Vitamin D is important to skeletal health and ensuring a replete vitamin D status is recommended. In thyrotoxicosis, bone turnover is increased and bone mass density (BMD) reduced. We examined whether vitamin D supplementation improves bone recovery in thyrotoxicosis caused by Graves' disease (GD).

methodsUsing a double-blinded design, hyperthyroid patients with GD were randomized to vitamin D3 70 µg/day (2800 IU) or similar placebo as add-on to antithyroid drugs (ATD). At baseline and 9 months, we measured BMD and bone architecture using DXA and high resolution peripheral quantitative computerized tomography. Bone turnover markers (BTM) were measured at 3 months also. Effect of vitamin D versus placebo and the response to ATD treatment were analyzed using linear mixed modelling.

resultsEighty-six GD patients were included (age 41 ± 14 years, 86% females). Compared to placebo, vitamin D3 did not improve BMD or microarchitecture. In response to ATD, BMD increased in the hip by 2% (95%CI: 1-4%). Cortical porosity decreased in tibia (- 7% [95%CI: - 12 to - 2%]) and radius [- 14% [95%CI: - 24 to - 3%]), and trabecular thickness increased (tibia (5% [95%CI: 2 - 9%]) and radius (4% [95%CI: 1-7%]). Changes in BTM, but not thyroid hormones, were associated with changes in BMD by DXA and with changes in the cortical compartment.

conclusionIn newly diagnosed GD, 9 months of high dose vitamin D3 supplementation does not offer benefit by improving skeletal health. Treatment of thyrotoxicosis is associated with the recovery of BMD and microarchitecture. CLINICALTRIAL: GOV IDENTIFIER: NCT02384668.

Indexed as

Absorptiometry, PhotonAntithyroid AgentsBone DensityBone RemodelingCholecalciferolDietary SupplementsGraves DiseaseAdultBone Density Conservation AgentsDouble-Blind MethodDrug Therapy, CombinationFemaleHumansLumbar VertebraeMaleMiddle AgedAntithyroid AgentsBone Density Conservation AgentsCholecalciferolVitamin DBone densityBone microarchitectureBone turnover markersGraves’ diseaseThyrotoxicosisVitamin D

Identifiers

PMID39264438
PMCPMC11579043

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.