Eldecalcitol improves mechanical strength of cortical bones by stimulating the periosteal bone formation in the senescence-accelerated SAM/P6 mice - a comparison with alfacalcidol

Comparative effect of eldecalcitol and alfacalcidol on bone microstructure: A preliminary report of secondary analysis of a prospective trial

Objectives

To compare the effect of eldecalcitol and alfacalcidol on skeletal microstructure by high-resolution peripheral QCT (HR-pQCT).

Methods

This was a substudy of a randomized, double-blind, active comparator trial. Five female osteoporotic patients with 1-year 0.75 μg/day eldecalcitol and 5 with 1-year 1.0 μg/day alfacalcidol completed HR-pQCT scans before and after treatment were enrolled.

Results

Total vBMD [1.67 ± 1.06% (mean ± SD), P = 0.043 versus baseline] and trabecular vBMD (2.91 ± 1.72%, P = 0.043) at the radius increased in eldecalcitol group, while total, trabecular, and cortical vBMD tended to decrease in alfacalcidol group, with a significant reduction in cortical vBMD at the tibia (0.88 ± 0.62%, P = 0.043). Cortical area (1.82 ± 1.92%, P = 0.043) at the radius and thickness (0.87 ± 1.12%, P = 0.043) at the tibia increased in eldecalcitol group, while these parameters decreased with alfacalcidol at the tibia (1.77 ± 1.72%, P = 0.043 for cortical area; 1.40 ± 2.14%, P = 0.042 for cortical thickness). Trabecular thickness at the radius (1.97 ± 1.93%, P = 0.042) and number at the tibia (3.09 ± 3.04%, P = 0.043) increased by eldecalcitol but did not increase by alfacalcidol. Trabecular separation decreased by eldecalcitol (2.22 ± 2.43%, P = 0.043) but tended to increase by alfacalcidol at the tibia.

Conclusions

Eldecalcitol has the greater potential to improve cortical and trabecular microstructure at the peripheral bone than alfacalcidol which needs further more studies.

Non-Compartmental Pharmacokinetics and Safety of Single-Dose Eldecalcitol (ED-71) in Healthy Chinese Adult Males

BACKGROUND AND OBJECTIVES

Eldecalcitol (ED-71) is a novel active vitamin D₃ derivative, used for the treatment of osteoporosis. This is the first clinical study to investigate the pharmacokinetics and safety of eldecalcitol in Chinese subjects.

METHODS

This was an open, single-center, randomized, two-dose level, two-period crossover phase I study in 24 healthy Chinese adult males. Eligible subjects received a single oral dose of eldecalcitol capsule 0.5 or 0.75 μg at period 1 or period 2, monitored over a 144-h observation period for pharmacokinetics and a 14-day observation period for safety. The wash-out time was 14 days. The data observed in this study were compared with historical data in Japanese subjects to evaluate the inter-ethnic differences in pharmacokinetics.

RESULTS

After single doses of 0.5 and 0.75 μg eldecalcitol, the maximum serum concentration (C_max) of eldecalcitol was reached within 3.0-4.0 h (C_max was 0.0638 ± 0.0076 ng/ml in the 0.5-μg group and 0.0944 ± 0.0126 ng/ml in the 0.75-μg group, area under the concentration-time curve from 0 to 24 h (AUC_(0-24h)) was 1.02 ± 0.15 ng·h/mL in the 0.5-μg group and 1.57 ± 0.26 ng·h/mL in the 0.75-μg group). The pharmacokinetic parameters was similar between the Chinese and Japanese subjects; both C_max and partial AUCs could be considered to be dose-proportional over the tested dose range of 0.5-0.75 µg in Chinese subjects, which was in line with previously published results on eldecalcitol linear pharmacokinetics (range 0.1-1.0 µg) in Japanese subjects. Alanine aminotransferase increase was the most common adverse event (AE). No drug-related serious AEs were reported. All of the drug-related AEs of eldecalcitol were mild in severity.

CONCLUSION

Pharmacokinetic exposure (C_max and partial AUCs) was dose-proportional over the tested dose range of 0.5-0.75 µg in healthy Chinese adult males. The pharmacokinetic character of eldecalcitol in Chinese subjects was similar to historical data from Japanese subjects. Eldecalcitol was well tolerated at doses ranging from 0.5 to 0.75 µg, with no new safety signals identified.

CLINICAL TRIAL REGISTRATION

This study was registered at the China Food and Drug Administration (Registration number: 2014L02212 and 2014L02213), and also registered at http://www.chinadrugtrials.org.cn (No. CTR20160430).

Effects of eldecalcitol on cortical bone response to mechanical loading in rats

Background

Mechanical loading of bones activates modeling and suppresses remodeling by promoting bone formation. Eldecalcitol is approved for the treatment of osteoporosis in Japan and is often used in patients undergoing exercise therapy. However, the effects of eldecalcitol on bone formation during mechanical loading are unknown. The aim of this study was to clarify the influence of eldecalcitol administration on bone response to mechanical loading using a four-point bending device.

Methods

Forty six-month-old female Wistar rats were randomized into four groups based on eldecalcitol dose (vehicle administration (VEH), low dose (ED-L), medium dose (ED-M), and high dose (ED-H)). Loads of 38 N were applied in vivo to the right tibia for 36 cycles at 2 Hz, by four-point bending, 3 days per week for 3 weeks. After calcein double-labeling, rats were sacrificed and tibial cross sections were prepared from the region with maximal bending at the central diaphysis. Histomorphometry was performed on the entire periosteal and endocortical surface of the tibiae, dividing the periosteum into lateral and medial surfaces.

Results

The effects of external loading on bone formation parameters were significant at all three surfaces. Bone formation parameters were highest in the ED-H group, and the effects of eldecalcitol on bone formation rate were significant at the endocortical surface. In addition, the interaction between loading and eldecalcitol dose significantly affected bone formation rate at the endocortical surface.

Conclusions

Eldecalcitol enhanced the cortical bone response to mechanical loading and a synergistic effect was observed in a rat model.