Use of Vitamin D Compounds in Medicine, Especially 1,25-Dihydroxyvitamin D₃

Abstract

The discovery of the vitamin D metabolites has ushered in a new era in the treatment of metabolic bone disease. Its utility as compared to the peptide hormones, known to play a role in calcium and phosphorus metabolism, lies in the fact that it is a steroid and can be administered orally with longer lasting effectiveness. It might be expected that there are diseases in which there is interference with 25-hydroxylation of vitamin D. So far this has not been clearly demonstrated, although it might be expected that biliary atresia has associated with it inadequate 25-hydroxylation. Phenobarbital and dilantin-induced osteomalacia is likely to be associated with low plasma levels of 25-OH-D₃, which suggests that these drugs may be inducing enzymes that destroy vitamin D and its metabolites (Hahn et al., 1972). This disease can be treated with either increased amounts of vitamin D or specifically with 25-OH-D₃ (Hahn and Avioli, 1977). The glucocorticoids have been shown to reduce plasma levels of 25-OH-D₃ (Klein et al., 1977), which suggests that the osteoporosis associated with glucocorticoid treatment might be improved or corrected by the administration of either 25-OH-D₃ or l,25-(OH)2D₃ (Klein et al., 1977).