title: Effects of teriparatide on serum calcium in postmenopausal women with osteoporosis previously treated with raloxifene or alendronate.
abstract: The effect of teriparatide (20 microg/day) on serum calcium was examined in postmenopausal women previously treated with alendronate or raloxifene. Women previously treated with alendronate or raloxifene who added teriparatide or switched to teriparatide did not have clinically meaningful increases in mean predose serum calcium.
  
  
  BACKGROUND
  The effects of a 6-month treatment with teriparatide (20 microg/day; rhPTH(1-34), TPTD) on serum calcium (Ca) was examined in a prospective study of postmenopausal women previously treated with alendronate (70 mg/week or 10 mg/day [ALN] or raloxifene 60 mg/d [RLX]) for > or =18 months.
  
  
  METHODS
  Women continued their usual ALN or RLX during a 2-month antiresorptive phase. Women previously treated with ALN were randomized to add TPTD (n = 52) or switch to TPTD (n = 50) and women previously treated with RLX were randomized to add TPTD (n = 47) or switch to TPTD (n = 49). All were to take at least 500 mg/day of elemental Ca and 400-800 IU/day of vitamin D.
  
  
  RESULTS
  Predose mean serum Ca did not significantly change in groups adding TPTD to either RLX or ALN treatment. In patients who switched from RLX or ALN to TPTD, mean serum Ca increased by 0.05 mmol/L and 0.04 mmol/L respectively. Only 1 patient had the predefined calcium endpoint of serum calcium > 2.76 mmol/L (11 mg/dL) at more than one visit.
  
  
  CONCLUSIONS
  Women previously treated with ALN or RLX who added TPTD or switched to TPTD did not have clinically meaningful increases in mean predose serum Ca.
authors.affiliation: Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Wermers
authors.forename: C P
authors.initials: CP
authors.lastname: Recknor
authors.forename: F
authors.initials: F
authors.lastname: Cosman
authors.forename: L
authors.initials: L
authors.lastname: Xie
authors.forename: E V
authors.initials: EV
authors.lastname: Glass
authors.forename: J H
authors.initials: JH
authors.lastname: Krege
mesh_terms: D000368:Aged; D019386:Alendronate / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood* / Q000652:urine; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis; D015663:Osteoporosis, Postmenopausal / Q000097:blood* / Q000188:drug therapy; D011446:Prospective Studies; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D019379:Teriparatide / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D004338:Drug Combinations; D019379:Teriparatide; D020849:Raloxifene Hydrochloride; D002118:Calcium; D019386:Alendronate