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Vitamin D supplements do not reduce risk of fracture due to falls

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DOI:10.1038/bonekey.2014.98

There have been calls for greater use of vitamin D supplementation to prevent fractures after falls but clinical trials and several meta-analyses have failed to demonstrate that vitamin D supplements bring about a clinically relevant improvement in bone mineral density or affect the incidence of hip fracture.

Bolland et al. assessed 20 randomized controlled clinical trials to find out if vitamin D supplementation was able to reduce the risk of falls by more than 15%. They used a trial sequential analysis technique (similar to cumulative meta-analysis), taking data from a total of 29,535 participants who had had a fall and who were assessed in intention-to-treat analyses.

Several different approaches were used but even when a risk reduction threshold of 10% was used, no benefit for vitamin D supplementation could be found. Neither was there any apparent advantage of providing vitamin D together with calcium supplements. The effect estimate calculated from six trials of vitamin D plus calcium (n=9919) still fell within the futility boundary.

Editor’s comment: No evidence can be found to justify prescribing vitamin D supplements to prevent fractures as a result of falls. As the authors note, it is unlikely that future trials will provide differing results.

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