Increase in the Serum Parathyroid Hormone Level During a Bisphosphonate Drug Holiday.
10.11005/jbm.2014.21.3.217
- Author:
Yoon Kyung SONG
1
;
Jeong Min KIM
;
Sun Jin PARK
;
Seong Kyu LEE
Author Information
1. Department of Internal Medicine, Nowon Eulji Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Bisphosphonate;
Calcium;
Parathyroid hormone;
Vitamin D
- MeSH:
Biomarkers;
Calcium;
Cholecalciferol;
Female;
Holidays*;
Humans;
Parathyroid Hormone*;
Phosphorus;
Vitamin D
- From:Journal of Bone Metabolism
2014;21(3):217-222
- CountryRepublic of Korea
- Language:English
-
Abstract:
After discontinuation of bisphosphonate therapy, an antiresorptive effect and antifracture protection persist for an undefined period. Patients are encouraged to continue calcium and vitamin D supplementation, during a bisphosphonate drug holiday. However, assessment of adequate calcium intake during the bisphosphonate drug holiday is difficult. Therefore, we measured the serum intact parathyroid hormone (PTH) level as a surrogate marker. A premenopausal woman discontinued bisphosphonate therapy, after 7.5 years of treatment. Two months later, blood calcium and phosphorus levels were normal, serum 25-hydroxyvitamin D level was 31.3 ng/mL, but serum PTH level had increased to 94.9 pg/mL. The elemental calcium supplement dose was increased to 600 mg/day, with no change in the cholecalciferol dose (400 IU). Her serum PTH levels decreased to 49.1 after 4 months and 32.9 pg/mL after 5 months. The serum PTH level may be helpful in assessing adequate calcium intake during a bisphosphonate drug holiday.
