Trends in serum phosphate, calcium, and parathyroid hormone levels according to renal function following denosumab
Authors' conclusion
This study suggests that denosumab induces a transient decrease in serum calcium and phosphate levels, accompanied by a significant increase in PTH levels, particularly during the first 1 to 3 months.
Study context
- Population
- Patients treated with denosumab at three Korean hospitals, November 2016–December 2021
- Participants
- 11,586 patients
- Exposure
- Chronic kidney disease (CKD) vs normal kidney function, following denosumab
- CKDn = 1,517
- Normaln = 10,069reference
- Outcome
- Mean percentage change in serum phosphate, calcium and PTH levels from baseline
- Follow-up
- 6 months post-treatment
Methodological detailsobservational, multicentre (three Korean hospitals)
- Observational
- Multicentre (three Korean hospitals)
Main finding
As reported in the abstract
Mean % change in serum phosphate, calcium and PTH
- Serum phosphate declined temporarily, returned to baseline within six months; no significant difference between CKD and normal
Observational data: associations, not effects.
Further findings
- Serum calcium, mean % change (CKD vs normal kidney function) · 1-3 months — Mean % change in calcium, CKD vs normal · greater decline in CKD
- - 6.48% vs. - 3.42% · P < 0.001
- Parathyroid hormone (PTH), mean % change (CKD vs normal kidney function) · 1-3 months — Mean % change in PTH, CKD vs normal · greater increase in CKD
- 200.84% vs. 124.34% · P < 0.001
- Serum calcium, mean % change (CKD vs normal kidney function) · 6 months — Mean % change in calcium, CKD vs normal · returned to baseline
- - 0.76% vs. - 0.67% · P = 0.650
- PTH, mean % change (CKD vs normal kidney function) · 6 months — Mean % change in PTH, CKD vs normal · returned to baseline
- 24.49% vs. 20.78% · P = 0.528
Serum phosphate · 6 months
- Temporary decline, returned to baseline within 6 months; no significant difference between CKD and normal
Safety
Hypocalcaemia
- Hypocalcemia more prevalent in CKD than in normal kidney function
Original publication
Trends in serum phosphate, calcium, and parathyroid hormone levels according to renal function following denosumab. Osteoporos Int. Published 12 July 2025. doi:10.
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