The effect of recombinant PTH(1-34) and PTH(1-84) on serum ionized calcium, 1,25-dihydroxyvitamin D, and urinary calcium excretion: a pilot study.
We investigated the frequency of hypercalcemia and/or hypercalciuria following parathyroid hormone (PTH) 1-34 and 1-84 administration in a crossover trial. Ten postmenopausal osteoporotic women previously treated with bisphosphonates were subdivided into two groups of five patients each. A 24-h urine collection to determine baseline calcium (Ca) and creatinine (Cr) the day before administration of PTH was followed by determination of serum ionized Ca (Ca(2+)), Cr, 25(OH)D, and 1,25(OH)(2)D at baseline. Thereafter, 100 mcg of PTH(1-84) or 20 mcg of PTH(1-34) was administered. A 24-h urinary collection and blood samples 2, 4, and 24-h after each PTH administration were again taken. One week after the first PTH administration patients were rechallenged with the second PTH. The PTH peptides did not differ with respect to changes in Ca(2+) at 2, 4, and 24 h postinjection; at the last time point the values were virtually identical to the initial values. There was no difference in urinary Ca on the day following PTH injection compared to baseline, in terms both of Ca/Cr and of Ca excretion. The two PTH peptides did not differ with respect to changes in 1,25(OH)(2)D at 2, 4, and 24 h considering both the absolute values and the percent changes with respect to baseline (24-h 1-84 = 125.6 + or - 58.6 pg/ml, 153% increase; 1-34 = 124.1 + or - 64.7, 130%). Our results indicate no difference in postinjection serum Ca(2+), 1,25(OH)(2)D, or urinary Ca excretion after a single dose of either PTH(1-84) or PTH(1-34) in patients previously treated with bisphosphonates.
Piemonte
Sara
S
Department of Clinical Sciences, University of Rome "Sapienza", Viale del Policlinico 155, 00161 Rome, Italy.
Romagnoli
Elisabetta
E
Cipriani
Cristiana
C
Fassino
Valeria
V
Del Fiacco
Romano
R
Carnevale
Vincenzo
V
Scillitani
Alfredo
A
D'Erasmo
Emilio
E
Tancredi
Andrea
A
Minisola
Salvatore
S
D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood* / Q000652:urine*; D003404:Creatinine / Q000652:urine; D018592:Cross-Over Studies; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000453:epidemiology / Q000378:metabolism; D053565:Hypercalciuria / Q000453:epidemiology / Q000378:metabolism; D007279:Injections, Subcutaneous; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000378:metabolism*; D010281:Parathyroid Hormone / Q000008:administration & dosage / Q000494:pharmacology*; D010865:Pilot Projects; D015995:Prevalence; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D004164:Diphosphonates; D010281:Parathyroid Hormone; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; D003404:Creatinine; D002118:Calcium