ECTS2013 Poster Presentations Osteoporosis: treatment (64 abstracts)
Parathyroid hormone changes following denosumab treatment in postmenopausal osteoporosis
Polyzois Makras 1 , Stergios Polyzos 2 , Athanasios Papatheodorou 3 , Panagiotis Kokkoris 1, , Daniel Chatzifotiadis 4 & Athanasios Anastasilakis 5
1Department of Endocrinology and Diabetes, 251 Hellenic Air Force and VA General Hospital, Athens, Greece; 2Ippokration Hospital,Second Medical Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece; 3Department of Medical Research, 251 Hellenic Air Force and VA General Hospital, Athens, Greece; 4Division of Nuclear Medicine, 251 Hellenic Air Force and VA General Hospital, Athens, Greece; 5Department of Endocrinology, 424 Military Hospital, Thessaloniki, Greece.
Purpose: Denosumab is a new potent antiresorptive treatment of osteoporosis that can potentially induce a compensatory increase of parathyroid hormone (PTH) levels. We aimed to evaluate the alteration of PTH 1 and 6 months after denosumab’s administration (60 mg) with different regimens of calcium and vitamin D (Ca/D) supplementation, as well as the association of PTH with serum Ca and bone markers.
Methods: This was a prospective, multicenter, study among 47 postmenopausal women requiring onset or continuation of osteoporosis treatment who were followed for 6 months. The intervention included administration of 1 g calcium carbonate and 800 IU cholecalciferol daily for 6 months (Group A) or the double dose (2 g/1600 IU) for the first month followed by the 1 g/800 IU Ca/D regimen for the next 5 months (Group B).
Results
PTH levels were significantly higher at month 1 and 6 only in Group A; Ca levels were significantly decreased at month 1 and returned to baseline values at month 6 within the same Group. The mean percent change between month 1 and baseline for PTH [Δ(PTH1-0)] was significantly higher in Group A than B (63.5±28.2 vs −3.0±4.7%, P=0.029). Δ(PTH1–0) was correlated with the reciprocal Δ-changes of Ca (rs=−0.610; P=0.002), and collagen type I C-terminal telopeptide (rs=−0.697; P=0.003) only in Group A.
Conclusion: An increase of PTH should be expected, at least following the first administration of denosumab in common clinical practice. The effect of this compensatory consequence in bone metabolism warrants further investigation.
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