Benefits, Drawbacks to Denosumab Tx in ESRD

Magnificent rates of treatment-related hypocalcemia

AUSTIN, Texas — Hypocalcemia was visit among end-stage renal suffering (ESRD) patients accounted for right with denosumab, concerting to a meta-analysis dispatched here.

Led by Prakrati C. Acharya, MBBS, of the University of Mississippi Medical Center, the distillation found an amount of denosumab-associated hypocalcemia was 42% (95% CI 29% to 55%) magnitude the 84 perseverants comprehended in the definitive inquiry.

Although there were consequential raises backfire in bone mineral density (BMD) suzerainty treatment — specially in the lumbar spicula (cruel dissimilarity 0.39, 95% CI 0.10-0.69, P=0.01) and femoral neck (MD 0.79, 95% CI 0.60-0.98, P<0.01) — this favoured with a valued tear in parathyroid hormone franks (homogenized MD -1.89, 95% CI -3.44 to 0.34, P=0.02).

Mounted at the Resident Kidney By design’s Foundation Clinical Spot, Acharya divulged MedPage Today that these finds direct notoriety to to “the embryonic efficacy of denosumab in the make the grade in BMD among ESRD constants on dialysis,” without kindliness the high amount of denosumab-associated hypocalcemia in these valetudinarians.

The think over and beyond found no payable changes in incidentals to serum phosphate crests (MD -0.10 mg/dL, 95% CI -0.70 to 0.49 mg/dL, P=0.74), and there were no exchanges in serum calcium directs when calcium and vitamin D magnitudes were applied (MD 0.20 mg/dL, 95% CI -0.30 to 0.69 mg/dL, P=0.44).

“With polite monitoring and copy adjustment in calcium dialysate, indifferent calcium and bustling vitamin supplementation, symptomatic hypocalcemia is potentially preventable in ESRD patients attended with denosumab,” Acharya detailed, but added that this discretion require cultivate investigation grouping randomized pilot pilots fact the scarcity of token in rupture status enhancement with interventions to renew BMD in these patients.

Their in happening analysis itemize six observational analyses, found from a circulars search of the Medline, Embase and Cochrane databases. Acharya delineated how her place initially elect to conduct this consider to assess both the pledge and efficacy of denosumab treatment in patients with ESRD.

“Come nighing 2.1 million osteoporosis-related bone chasms are reported each year in the U.S., effecting in as much as $20.3 billion annual upfront health fees,” she highlighted. “In ESRD long-sufferings, the mastery of osteoporosis classifies from 13% up to 80% and hip rupture be entitled ti are 4- to 17-fold stupendous than in the general population.”

Providers be compelled look to substitutes beyond the typically demanded bisphosphonate treatment for osteoporosis due to in the works FDA recommendations singing against their use in dialysis patients, as these factors are removed to the nth degree dialysis.

“This asserts it a definite needfulness to look into newer ingredients,” described Acharya.

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