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Risk Analysis of Denosumab-Induced Hypocalcemia in Bone Metastasis Treatment : Renal Dysfunction Is Not a Risk Factor for Its Incidence in a Strict Denosumab Administration Management System with Calcium/Vitamin D Supplementation
| Title: | Risk Analysis of Denosumab-Induced Hypocalcemia in Bone Metastasis Treatment : Renal Dysfunction Is Not a Risk Factor for Its Incidence in a Strict Denosumab Administration Management System with Calcium/Vitamin D Supplementation |
| Authors: | Saito, Yoshitaka Browse this author →KAKEN DB | | Takekuma, Yoh Browse this author →KAKEN DB | | Komatsu, Yoshito Browse this author →KAKEN DB | | Sugawara, Mitsuru Browse this author →KAKEN DB |
| Keywords: | denosumab | | hypocalcemia | | pharmaceutical management | | calcium supplementation | | risk factor | | renal dysfunction |
| Issue Date: | 1-Dec-2021 |
| Publisher: | The Pharmaceutical Society of Japan |
| Journal Title: | Biological & pharmaceutical bulletin |
| Volume: | 44 |
| Issue: | 12 |
| Start Page: | 1819 |
| End Page: | 1823 |
| Publisher DOI: | 10.1248/bpb.b21-00653 |
| Abstract: | We have reported that a strict denosumab administration management system with oral calcium/ vitamin D supplementation attenuates denosumab-induced hypocalcemia in 158 cancer patients with bone metastasis. In this report, 27.8% of the patients experienced hypocalcemia, including 0.6% with grade 2. So far, the risk factors for >= grade 2 hypocalcemia incidence have been identified in denosumab- treated cancer patients, including patients without calcium/vitamin D supplementation. Therefore, the present study aimed to reveal the factors that affect all-grade hypocalcemia incidence with calcium/vitamin D supplementation and team medical care according to the management system. A receiver operating characteristic curve analysis suggested that the cutoff of baseline serum calcium level for all-grade hypocalcemia incidence was 9.3 mg/dL. Multivariate analysis revealed that age >= 65 years (odds ratio, 95% confidence interval: 2.57, 1.11- 5.95, p = 0.03), grade 1 or higher serum alkaline phosphatase elevation (3.70, 1.71- 8.00, p < 0.01), an adjusted serum calcium level of less than 9.3 mg/dL (3.21. 1.25-8.24, p = 0.02) at baseline, and co-administration of cytotoxic agents (2.33, 1.06-7.11, p = 0.03) are risk factors for the incidence of allgrade hypocalcemia. However, renal dysfunction, which has been suggested to be a risk factor in previous reports, was not a factor. In conclusion, we revealed the risk factors for all-grade hypocalcemia in calcium/vitamin D supplementation and awareness, as demonstrated by the management system. Moreover, renal dysfunction was not a risk factor in our strict denosumab administration management system. Our results support the value of early detection of hypocalcemia incidence to guide the selection of an appropriate management strategy. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/84574 |
| Appears in Collections: | 国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
薬学研究院 (Faculty of Pharmaceutical Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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