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Denosumab‐associatedhypocalcaemia:incidence, severityand patientcharacteristics in atertiary hospitalsetting Andrew HuynhScott T. BakerAndrew J. Stewardson2016 год

Denosumab‐associated hypocalcaemia: incidence, severity and patient characteristics in a tertiary hospital setting
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Аннотация: Abstract Purpose Denosumab‐associated hypocalcaemia (DAH) has been reported in patients with osteoporosis or metastatic bone disease and is associated with stages 4 and 5 chronic kidney disease (CKD, estimated glomerular filtration rate <30 mL/min/1.73m 2 ). Other risk factors for hypocalcaemia have not been fully elucidated. We aimed to investigate the incidence of hypocalcaemia amongst patients receiving denosumab and to identify clinical features associated with this adverse event. Methods Retrospective cohort study between June 2013 and June 2014 of patients administered denosumab (60/120 mg) at a tertiary hospital in Melbourne, Australia, to identify the incidence of an albumin‐adjusted serum calcium concentration <2.10 mmol/L or ionized calcium <1.13 mmol/L within 6 months of treatment. Univariable and multivariable logistic regression analyses were performed to identify clinical features associated with DAH. Results One hundred and fifty‐five patients were administered denosumab (100 osteoporosis, 55 bone metastases). Twenty‐two patients (14% [95%CI 9.1–20.7]) developed hypocalcaemia: 55% were men, and 55% had osteoporosis. Eighty‐six per cent had a 25‐hydroxyvitamin D concentration >50 nmol/L, and 91% were on calcium/colecalciferol supplementation. Stages 4 and 5 CKD (adjusted odd ratio [aOR] 4.71, 95%CI 1.61–13.79, p = 0.005) and male sex (aOR 4.30, 95%CI 1.69–10.96, p = 0.002) were associated with DAH. No patients were documented as having hypocalcaemic symptoms. One patient received intravenous calcium gluconate treatment. Conclusions The incidence of denosumab‐associated hypocalcaemia was 14% (95%CI 9.1–20.7) within 6 months of treatment despite widespread use of appropriate calcium/colecalciferol supplementation. Stages 4 and 5 CKD and male sex were associated with subsequent hypocalcaemia. Copyright © 2016 John Wiley & Sons, Ltd.
Год издания: 2016
Авторы: Andrew Huynh, Scott T. Baker, Andrew J. Stewardson, Douglas Johnson
Издательство: Wiley
Источник: Pharmacoepidemiology and Drug Safety
Ключевые слова: Bone health and treatments, Medical Imaging and Pathology Studies, Parathyroid Disorders and Treatments
Другие ссылки: Pharmacoepidemiology and Drug Safety (HTML)
PubMed (HTML)