From the Guidelines
Evenity (romosozumab) does not directly affect parathyroid hormone (PTH) levels as its primary mechanism of action, and clinical studies have not shown significant or consistent changes in PTH levels with Evenity treatment. Evenity works by inhibiting sclerostin, which increases bone formation while simultaneously decreasing bone resorption. While Evenity doesn't directly target PTH, there may be indirect effects on calcium homeostasis that could influence PTH secretion. When Evenity increases bone formation, it can incorporate more calcium into bone, potentially leading to transient decreases in serum calcium. This could theoretically trigger a compensatory increase in PTH secretion by the parathyroid glands to maintain normal calcium levels.
Key Points to Consider
- The primary mechanism of action of Evenity is the inhibition of sclerostin, which leads to increased bone formation and decreased bone resorption 1.
- Clinical guidelines recommend the use of Evenity for the treatment of osteoporosis in adults at high or very high risk of fracture, with an emphasis on optimizing dietary and supplemental calcium and vitamin D intake 2.
- Patients taking Evenity should have their calcium levels monitored, and adequate calcium and vitamin D supplementation is recommended during treatment to maintain normal calcium homeostasis and prevent any potential secondary changes in PTH levels.
- The American College of Physicians and the American College of Rheumatology provide guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis, which include recommendations for the use of Evenity in specific patient populations 2.
Monitoring and Supplementation
- Regular monitoring of calcium levels is essential for patients taking Evenity to prevent potential secondary changes in PTH levels.
- Adequate calcium and vitamin D supplementation is crucial during Evenity treatment to maintain normal calcium homeostasis.
- The recommended dietary allowance for calcium and vitamin D should be followed, and supplementation should be adjusted accordingly 2.
From the Research
Effect of Evenity (Romosozumab) on Parathyroid Hormone (PTH) Levels
- The effect of Evenity (romosozumab) on parathyroid hormone (PTH) levels is mentioned in a study published in the European journal of pharmacology 3, which states that neutralizing sclerostin alters calcium homeostasis and increases PTH.
- Another study published in the same journal does not provide direct information on the effect of romosozumab on PTH levels.
- The other studies provided do not mention the specific effect of Evenity (romosozumab) on PTH levels, but rather discuss its mechanism of action, efficacy, and safety in the treatment of osteoporosis 4, 5, 6, 7.
- It is worth noting that romosozumab has a dual effect on bone, increasing formation and decreasing resorption, which is similar to the effect of PTH, but with an additional anti-catabolic effect 3.
Key Findings
- Romosozumab increases bone formation and decreases bone resorption 5, 3, 7.
- The treatment with romosozumab should be followed by an antiresorptive agent to maintain or increase bone mineral density and reduce fracture risk 5, 7.
- Romosozumab has been shown to be effective in treating osteoporosis, with a rapid and significant gain in bone mineral density 5, 7.