Observational studyBMC cancer2024
Denosumab-induced hypocalcemia in patients with solid tumors and renal dysfunction: a multicenter, retrospective, observational study.
Observational study in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 6 citations in OpenAlex.
- Mining the FAERS database reveals new safety signals for 120 mg denosumab in oncology practice.PloS one · 2026Article
- Synergistic Efficacy of Calcitriol Combined with Denosumab versus Calcitriol Alone in Postmenopausal Osteoporosis: A Retrospective Cohort Study.International journal of women's health · 2026Article
- Managing Bone Metastases with Denosumab: Real-World Data and Critical Monitoring Points in Breast, Lung, and Prostate Cancers.Medicina (Kaunas, Lithuania) · 2025Article
- Refractory Denosumab-induced Hypocalcemia in a High-risk Patient With Osteoblastic Metastatic Prostate Adenocarcinoma.JCEM case reports · 2025Article
- Role of Denosumab in Patients with Intermediate Spinal Instability Neoplastic Score (SINS).Cancers · 2025Article
- Association between allopurinol and hepatocellular carcinoma: analysis of genetic risk and patient survival.Discover oncology · 2025Article
- Asymptomatic Hypocalcemia Related to Denosumab Administration in Bone-Metastatic Patient Affected by Colorectal Cancer: A Case Report.Endocrine, metabolic & immune disorders drug targets · 2025Article
- Switching from Zoledronic Acid to Denosumab for Bone Modification Therapy in Patients with Malignant Tumors and Renal Insufficiency: A Retrospective Case Series and Literature Review.Case reports in oncologyArticle
Corrections and comments
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Authors and funding
16 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBone metastases are frequently observed in advanced cancer, and bone modifying agents are used to prevent or treat skeletal-related events. Zoledronic acid is contraindicated in patients with severe renal impairment (Ccr < 30 mL/min), but it is not completely known whether denosumab can be used in them. We aimed to determine the association between renal function and hypocalcemia development during denosumab treatment.
methodsWe included patients with solid cancer and bone metastases who started denosumab treatment between April 2017 and March 2019. They were classified into four groups based on creatinine clearance (Ccr; mL/min): normal (Ccr ≥ 80), mild (50 ≤ Ccr ˂80), moderate (30 ≤ Ccr ˂50), and severe (Ccr ˂30). Hypocalcemia was evaluated using the Common Terminology Criteria for Adverse Events (v5.0) based on the albumin-adjusted serum calcium levels; its incidence (stratified by renal function) and risk factors were investigated using a Chi-square test and logistic regression analysis.
resultsOf 524 patients (age: 69 ± 11 years; 303 men), 153 had a normal renal function and 222, 117, and 32 had mild, moderate, and severe renal dysfunction. The albumin-adjusted serum calcium level was higher than the measured (total) calcium level in most patients. The incidence of grade ≥ 1 hypocalcemia was 32.0% in the normal group and 37.4%, 29.9%, and 62.5% in the mild, moderate, and severe renal dysfunction groups, respectively. It was, therefore, higher in the severe renal dysfunction groups than in the normal group (P = 0.002). The incidence of grade ≥ 3 hypocalcemia did not differ significantly among the groups. Pre-treatment low serum calcium levels and severe renal dysfunction were risk factors for hypocalcemia.
conclusionsEvaluating denosumab-induced hypocalcemia required albumin adjustment, and its incidence was high among patients with severe renal dysfunction. Reduced serum calcium levels and severely impaired renal function were associated with an elevated hypocalcemia risk.
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