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01-03-2019 | Original Article

Potential association with early changes in serum calcium level after starting or switching to denosumab combined with eldecalcitol

Authors: Tsuyoshi Asano, Tomohiro Shimizu, Daisuke Takahashi, Masahiro Ota, Dai Sato, Hiroki Hamano, Shigeto Hiratsuka, Masahiko Takahata, Norimasa Iwasaki

Published in: Journal of Bone and Mineral Metabolism | Issue 2/2019

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.

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Title: Potential association with early changes in serum calcium level after starting or switching to denosumab combined with eldecalcitol
Authors: Tsuyoshi Asano
Tomohiro Shimizu
Daisuke Takahashi
Masahiro Ota
Dai Sato
Hiroki Hamano
Shigeto Hiratsuka
Masahiko Takahata
Norimasa Iwasaki
Publication date: 01-03-2019
Publisher: Springer Japan
Published in: Journal of Bone and Mineral Metabolism / Issue 2/2019
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-018-0928-x

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