E053 Denosumab-induced hypocalcaemia in patients with low eGFR: a case series
Abstract
There are limited therapeutic options for treating patients with severe osteoporosis and chronic kidney disease, especially those with an estimated glomerular filtration rate (eGFR) of < 30ml/min/1.732. These patients often have a very high risk of morbidity and mortality associated with a major osteoporotic fracture. Denosumab is effective at reducing the risk of osteoporotic fractures; however, it is associated with a risk of hypocalcaemia. We audited the risk of developing significant hypocalcaemia in patients with low eGFR taking denosumab for osteoporosis.
We present a small retrospective case series on patients with eGFR 50nmol/L). Blood monitoring of serum corrected calcium (cCa2+) was completed every 2 weeks for 6 weeks post denosumab injection (2, 4 and 6 weeks). All patients received high-dose Vitamin D3 as colecalciferol 20,000iu for 6 weeks (week 2, 4 and 6).
We terminated the audit after treating seven female patients (age 74-95 years). There were six Caucasian and one South Asian patient. Six patients had a history of multiple fractures and one patient had been taking letrozole. The median baseline eGFR was 24 (4-31) ml/min/1.732, and mean baseline serum cCa2 + (at time of 1st injection) was 2.44 mmol/l (2.22-2.65). At 2 weeks, the mean serum cCa2+ was 2.14 mmol/l (1.54-2.51), at week 4, 2.24 mmol/l (1.90.2.51) and at week 6, 2.25 mmol/l (1.94-1.41). Two out of seven patients developed severe hypocalcaemia in week 2 (1.54 mmol/l and 1.62 mmol/l) with emergency…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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