Effectiveness of Calcium and Vitamin D3 Supplementation in Secondary Osteoporosis: A Retrospective Cohort Analysis

BackgroundSecondary osteoporosis may occur in patients with underlying conditions or exposures that affect bone health.Calcium and vitamin D3 supplementation is frequently used as part of the management of these patients.However, real-world data evaluating changes in bone mineral density (BMD) following supplementation in patients with secondary osteoporosis are limited.This study evaluated changes in BMD following calcium and vitamin D3 supplementation in patients with secondary osteoporosis. MethodsThis retrospective, multicenter cohort study included 12,415 adult patients (≥18 years) diagnosed with secondary osteoporosis across India.Data were collected from electronic medical records.Variables included supplementation patterns, adherence, and treatment regimens.The primary outcome was clinician-assessed change in BMD/T-score during routine clinical follow-up, categorized as improved, unchanged, or declined.Associations between categorical outcomes and baseline/treatment characteristics were evaluated using chisquare tests. ResultsA total of 12,415 patients (mean age 52.2 ± 10.5 years) were included.Calcium and vitamin D3 supplementation were prescribed in 82.6% and 76.8% of patients, respectively, with combination therapy used in 55.1%.Based on clinician assessment, 8,887 patients (71.6%) demonstrated improvement in BMD/Tscore, 609 (4.9%) showed no change, and 2,919 (23.5%) experienced a decline during follow-up.Fractures were reported in 2,379 patients (19.2%).Significant associations were observed between BMD/T-score outcomes and supplementation, treatment regimen, adherence, regimen modification, and fracture history (all p < 0.001).Combination therapy was associated with the highest proportion of T-score improvement (80.8%), compared with vitamin D3 alone (69.8%) and calcium alone (51.4%) (p < 0.001).Higher adherence was significantly associated with improved treatment outcomes (p < 0.001).Fractures occurred in 19.2% of patients during follow-up. ConclusionCalcium and vitamin D3 supplementation was associated with favorable clinician-assessed BMD outcomes among patients with secondary osteoporosis in routine clinical practice.Combination therapy and high treatment adherence were associated with more favorable outcomes.These findings provide real-world insights into the use of calcium and vitamin D3 supplementation in the management of secondary osteoporosis.