Searchable abstracts of presentations at key conferences on calcified tissues
Bone Abstracts (2014) 3 PP85 | DOI: 10.1530/boneabs.3.PP85

ECTS2014 Poster Presentations Bone development/growth and fracture repair (55 abstracts)

The impact on calcium metabolism when replacing intact PTH with teriparatide treatment in patients with hypoparathyroidism

Lise Sofie Andersen , Tanja Sikjaer & Lars Rejnmark


Department of Endocrinology and Internal Medicine, Aarhus, Denmark.


PTH replacement therapy in hypoparathyroidism (hypoPT) has become more accepted after proving successful in several clinical studies. Intact PTH (PTH1–84) was in 2012 withdrawn, leaving teriparatide (PTH1–34) the only therapeutic option available.

All patients with postoperative HypoPT who changed medication from PTH1–84 (100 μg) to PTH1–34 (20 μg), after at least 12 months of conventional therapy and a minimum of 6 months of PTH1–84 were included. The following treatment with PTH1–34 was for at least 3 months. Plasma ionized calcium, daily dose of 1α-hydroxylated-vitamin D metabolites (Etalpha), calcium and PTH was collected.

Eight patients (women=88%) with a mean age of 54±12 years and a duration of hypoPT of 13±6 years were included. Before initiation of PTH1-84 the mean daily dose of Etalpha was 1.9±1.1 μg and calcium supplements were 1550±705 mg. Etalpha dose was reduced with 86±35% (P=0.01) after 6 months of PTH1–84 treatment and terminated in seven patients. Calcium were reduced with 78±36% (P=0.02) to 273±353 mg and stopped in four patients. Six patients received 100 μg PTH1–84 a day, the seventh received PTH 2 out of 3 days and the last one received PTH1–84 every other day.

When changing from PTH1–84 to PTH1–34, plasma ionized calcium initially dropped and the demand for supplements increased. Etalpha was resumed in four patients; mean daily dose increased to 0.99±1.26 μg (P=0.04) and calcium increased to 329±368 mg (P=0.72). Five patients received 20 μg PTH1-34 a day; two patients twice a day and one 20/40 μg alternately.

Compared with PTH1–34, PTH1–84 has a longer plasma half-life and a higher calcemic response. We have shown a need for higher doses of Etalpha and calcium supplements to maintain normal serum calcium when treated with PTH1–34 compared to PTH1–84 and in some a need for more than one daily dose.

Volume 3

European Calcified Tissue Society Congress 2014

Prague, Czech Republic
17 May 2014 - 20 May 2014

European Calcified Tissue Society 

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