Prevalence of denosumab-induced hypocalcemia: a retrospective observational study of patients routinely monitored with ionized calcium post-injection
Authors' conclusion
Denosumab-induced hypocalcemia is a prevalent adverse event, which occurs independently of the number of injections. However, severe hypocalcemia is a rare occurrence, and severe renal failure and nutritional status appear to be important predictive factors. Magnesium and phosphate might add value in the pre-injection risk assessment; however, this observation needs to be confirmed in larger cohorts.
Study context
- Population
- Real-world cohort treated with DMAB, routinely followed up with ionized calcium pre- and post-injection (within 31 days), 2011–2020; mean age at first injection 74 ± 10 years, 88% female1,096 injections
- Participants
- 242 participants
- Outcome
- Prevalence of hypocalcemia after DMAB injection
- Follow-up
- Within 31 days after injection
Methodological detailsreal-world cohort, routine ionized calcium monitoring pre- and post-injection
- Real-world cohort
- Routine ionized calcium monitoring pre- and post-injection
Main finding
As reported in the abstract
Post-injection hypocalcemia (per injection)
- Hypocalcemia, all injections
- 6.3%
- Mild
- 4.6%
- Moderate
- 0.6%
- Severe
- 1.1%
- Independent of number of injections; rate varied
- 3-8%
Observational data: associations, not effects.
Further findings
- Risk factors: male sex, severe renal failure, pre-injection hypocalcemia, hypomagnesemia, hypophosphatemia, vitamin D insufficiency
- Older age not associated with increased hypocalcemia risk
Original publication
Prevalence of denosumab-induced hypocalcemia: a retrospective observational study of patients routinely monitored with ionized calcium post-injection. Osteoporos Int. Published 26 September 2023. doi:10.
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