Potential Association with Early Changes in Serum Calcium Level After Starting or Switching to Denosumab Combined with Eldecalcitol

Overview

Journal J Bone Miner Metab

Specialty Endocrinology

Date 2018 May 4

PMID 29721807

Citations 3

Authors

Tsuyoshi Asano

Tomohiro Shimizu

Daisuke Takahashi

Masahiro Ota

Dai Sato

Hiroki Hamano

Shigeto Hiratsuka

Masahiko Takahata

Norimasa Iwasaki

Affiliations

Soon will be listed here.

Abstract

The aims of this study are to investigate changes in serum calcium (Ca) level after switching from either non-therapy, bisphosphonate, selective estrogen receptor modulators (SERM) or teriparatide treatments to a combination therapy of denosumab (DMAb), and eldecalcitol, and the association between early changes in serum calcium and changes in bone metabolic markers and bone mineral density (BMD). 129 patients with postmenopausal osteoporosis (32 non-pretreatment, 50 bisphosphonates, 18 SERM, and 29 teriparatide) were recruited and switched to DMAb plus eldecalcitol. Serum calcium levels, bone metabolism markers, and BMD measurements of the lumbar spine and femoral neck were evaluated. All groups showed an increase in BMD 6 months and 1 year after DMAb administration compared to baseline via suppression of bone metabolism markers. The TPD group showed a significant decrease in serum calcium level 1 week after the first injection of DMAb and eldecalcitol compared to baseline and the bisphosphonate group. Changes in serum calcium level from baseline to 1 week after the first injection of DMAb trended to correlate with changes in bone metabolism markers and lumbar BMD. The risks of DMAb-induced hypocalcemia are different between starting and switching from bone resorption inhibitors and bone formation promoters. Therefore, appropriate assessment before administration of DMAb, including pretreatment therapy as well as serum Ca and bone metabolic markers will help identify the risk of hypocalcemia following DMAb in combination with eldecalcitol. Our findings also showed that early change in serum Ca level after DMAb initiation could potentially predict the efficacy for therapy reaction.

Citing Articles

Short-term efficacy and safety of zoledronate acid or denosumab in Japanese patients with postmenopausal osteoporosis.

Nakamura Y, Shimizu T, Asano T, Shimodan S, Ishizu H, Takahashi D J Bone Miner Metab. 2021; 39(5):824-832.

PMID: 33821302 PMC: 8021003. DOI: 10.1007/s00774-021-01221-6.

Denosumab-induced hypocalcemia in patients with osteoporosis: can you know who will get low?.

Tsvetov G, Amitai O, Shochat T, Shimon I, Akirov A, Diker-Cohen T Osteoporos Int. 2019; 31(4):655-665.

PMID: 31838550 DOI: 10.1007/s00198-019-05261-7.

High bone turnover status as a risk factor in symptomatic hypocalcemia following denosumab treatment in a male patient with osteoporosis.

Ishikawa K, Nagai T, Tsuchiya K, Oshita Y, Kuroda T, Ito H Clin Interv Aging. 2018; 13:1929-1934.

PMID: 30349211 PMC: 6183698. DOI: 10.2147/CIA.S180614.

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