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https://hdl.handle.net/2115/84574

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

英語

renal dysfunction

2021-12-01

日本薬学会

Biological & pharmaceutical bulletin

44(12)

1819-1823

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.

学術雑誌論文

Version of Record

0918-6158