Starting Dose of Yorvipath
The recommended starting dose of Yorvipath (palopegteriparatide) is 18 μg/day administered subcutaneously, with subsequent titration based on serum calcium levels and clinical response. 1
Initial Dosing Protocol
- Start at 18 μg/day subcutaneously as the standard initial dose for adult patients with hypoparathyroidism 1
- Administer the dose once daily via subcutaneous injection 1
- Titrate the dose alongside conventional therapy (calcitriol and calcium supplementation) based on individual patient response 1
Dose Titration Strategy
- Adjust dosing based on serum calcium monitoring to maintain levels within the normal reference range (8.3-10.6 mg/dL) 1
- The goal is to gradually reduce or eliminate conventional therapy requirements while maintaining normocalcemia 1
- Dose adjustments should be individualized, with real-world data showing no clinically meaningful differences (>3 μg) in final doses between patients who switched directly from short-lived PTH therapy versus those who did not 1
Transitioning from Other PTH Therapies
- Patients can transition directly from short-lived PTH or PTH-related protein therapy (such as teriparatide or recombinant human PTH [1-84]) to palopegteriparatide at the 18 μg/day starting dose 1
- In real-world practice, approximately 50% of patients switched directly from short-lived PTH therapy without a washout period 1
- Direct switching does not require dose modification from the standard 18 μg/day starting dose 1
Clinical Monitoring
- Monitor serum calcium levels regularly during dose titration to ensure maintenance within normal range 1
- Track conventional therapy requirements (calcitriol and calcium) as these should decrease over time with effective palopegteriparatide treatment 1
- The proportion of patients achieving independence from conventional therapy (no calcitriol and ≤600 mg/day elemental calcium) increases progressively over 12 months of treatment 1