Evidence-based On-call

Hypercalcaemia

Prevention

Repeat the pamidronate infusion (60 mg) every 2 weeks ^a

Why?

Regular doses every 2 weeks compared with every 3 weeks reduce recurrent symptomatic hypercalcaemia ^a
It increases survival (by roughly 2 weeks) ^a

Pamidronate given every 2 weeks reduces symptomatic hypercalcaemia

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
malignancy and hypercalcaemia ^a	pamidronate every 2 weeks	pamidronate every 3 weeks	symptomatic hypercalcaemia at 16 weeks	53%	78% (12% to 94%)	2 (1 to 8)