A Systematic Review Supporting the Endocrine Society Clinical Practice Guideline on the Treatment of Hypercalcemia of Malignancy in Adults
Authors' conclusion
The evidence summarized in this systematic review addresses the benefits and harms of treatments of hypercalcemia of malignancy. Additional information about patients' values and preferences, and other important decisional and contextual factors is needed to facilitate the development of clinical recommendations.
Study context
- Population
- Adults with hypercalcemia of malignancy; 8 clinical questions prioritized by an Endocrine Society guideline panel21 studies
- Comparison
- Treatments of hypercalcemia of malignancy
- Outcome
- Resolution of hypercalcemia
Methodological detailsGrading of Recommendations Assessment, Development and Evaluation (GRADE) certainty assessment, quantitative and qualitative synthesis, 1949 citations reviewed, 21 studies included
- GRADE certainty assessment
- Quantitative and qualitative synthesis
- 1949 citations reviewed, 21 studies included
Pooled result
As reported in the abstract
- Refractory/recurrent hypercalcemia of malignancy, denosumab after bisphosphonate: resolution of hypercalcemia
- Two-thirds of patients
Further pooled results
High-calcitriol tumors, refractory/recurrent disease after bisphosphonates, calcimimetics in parathyroid carcinoma
- Only indirect evidence was available
Safety
- Incidence rate of adverse events significantly higher with bisphosphonate (vs placebo)
Original publication
A Systematic Review Supporting the Endocrine Society Clinical Practice Guideline on the Treatment of Hypercalcemia of Malignancy in Adults. J Clin Endocrinol Metab. Published 21 December 2022. doi:10.
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