Prognosis

Intravenous hydration and pharmacological therapy for malignancy-associated hypercalcaemia can provide transient restoration of normocalcaemia. Eradication of underlying malignancy is crucial for permanent reversal of hypercalcaemia.

Humoral hypercalcaemia of malignancy or local osteolytic hypercalcaemia

Intravenous hydration and calcitonin may improve hypercalcaemia within the first 24-48 hours of therapy.[1][28][29] Intravenous bisphosphonates are most efficacious and may restore normocalcaemia within 10 days of treatment in the majority of patients.[1][26] Duration of effect is variable.[26] Sustained resolution of hypercalcaemia requires effective anti-tumour therapy.

Calcitriol (1,25-dihydroxyvitamin D)-mediated hypercalcaemia

Intravenous hydration and calcitonin may transiently improve hypercalcaemia within the first 24-48 hours of therapy.[1][28][29] Glucocorticoid therapy requires several days to improve serum calcium levels.[34] Duration of effect has not been extensively studied.

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