Recommended treatment for adults with HCM is intravenous (IV) hydration and IV bisphosphonate (BP) or denosumab (Dmab). For acute HCM, Dmab treatment versus management with IV BP is suggested.
Suggested treatment for adults with severe HCM (serum calcium level >14 mg/dL) is combination therapy with calcitonin and an IV BP or Dmab.
If HCM treated with IV BP proves to be refractory or recurrent, Dmab therapy is suggested.
It is suggested that IV BP or Dmab be added to the treatment of hypercalcemia resulting from high calcitriol levels, in patients experiencing symptomatic or severe hypercalcemia despite glucocorticoid therapy.
Calcimimetic and/or antiresorptive therapy can be used in HCM caused by parathyroid carcinoma, depending on the HCM's severity and the initial treatment's outcome.
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Cite this: Hypercalcemia of Malignancy Clinical Practice Guidelines (ES, 2023) - Medscape - Mar 01, 2023.