Denosumab Linked to High Incidence of Severe Hypocalcemia in Female Dialysis Patients 65 and Above: JAMA
Osteoporosis, common in postmenopausal women, involves reduced bone density, fragile bones, and a higher fracture risk. Patients with advanced chronic kidney disease (CKD) have an elevated fracture risk. Dialysis-dependent older patients face a high risk of low bone mass due to primary osteoporosis, CKD–mineral and bone disorder (CKD-MBD), or both.
According to an Original Investigation published in JAMA, the use of Denosumab in elderly, female dialysis-dependent patients resulted in a statistically and clinically significant higher risk of severe hypocalcemia when compared to oral bisphosphonates.
Dialysis patients face high morbidity from fractures with limited evidence of optimal treatment. Chronic kidney disease-mineral and bone disorder is prevalent, complicating diagnosis and treatment of fragility.
The study examined the incidence and comparative risk of severe hypocalcemia with Denosumab compared with oral bisphosphonates among dialysis-dependent female patients aged 65 years or older treated for osteoporosis. Exposure included 60 mg of Denosumab or oral bisphosphonates. Severe hypoglycemia [total albumin-corrected serum calcium below 7.5 mg/dL (1.88 mmol/L)] and very severe hypocalcemia [serum calcium below 6.5 mg/dL [1.63 mmol/L]were assessed.
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