Skip to main content

Risk for Emergently Treated Hypocalcemia With Denosumab Rises With CKD Stage

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 19, 2024.

By Elana Gotkine HealthDay Reporter

TUESDAY, Nov. 19, 2024 -- For patients with chronic kidney disease (CKD), the risk for emergently treated hypocalcemia with denosumab increases with worsening CKD stage, according to a study published online Nov. 19 in the Annals of Internal Medicine.

Steven T. Bird, Ph.D., Pharm.D., from the U.S. Food and Drug Administration in Silver Spring, Maryland, and colleagues conducted a target trial emulation to examine the risk for emergently treated hypocalcemia with denosumab by stage of CKD and presence of CKD-mineral and bone disorder (MBD) among female patients aged 65 years or older. Participants initiated denosumab (361,453 patients), oral bisphosphonates (829,044 patients), or intravenous bisphosphonates (160,413 patients) for osteoporosis.

The researchers found that with denosumab versus oral bisphosphonates, the risk for emergently treated hypocalcemia increased with worsening CKD stage, with the highest risk seen among dialysis-dependent patients (3.01 versus 0.0 percent) and non-dialysis-dependent patients with CKD stages 4 and 5 (0.57 versus 0.03 percent). Among patients with stages 4 and 5 CKD, denosumab exhibited a higher risk for emergently treated hypocalcemia versus oral bisphosphonates in those with CKD-MBD (1.53 versus 0.02 percent) than in those without CKD-MBD (0.22 versus 0.03 percent). Increased risk was also seen for denosumab versus intravenous bisphosphonates.

"The highest incidence was seen in patients with advanced CKD and those with CKD-MBD," the authors write. "Diagnosis and management of skeletal fragility in these high-risk patients is complex, requiring careful patient selection, adequate supplementation with calcium and vitamin D, and frequent monitoring of serum calcium under supervision of a clinician with expert knowledge and experience treating CKD-MBD."

Abstract/Full Text (subscription or payment may be required)

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2025 HealthDay. All rights reserved.

Posted November 2024

Read this next

Higher Temperatures Tied to Greater Risk for Mortality in People Undergoing Dialysis

WEDNESDAY, April 23, 2025 -- Moderately elevated ambient temperature is associated with increased mortality in patients undergoing dialysis, according to a study published in the...

Proinflammatory Diet Tied to Higher Risk for Chronic Kidney Disease

WEDNESDAY, April 23, 2025 -- Individuals who eat a proinflammatory diet have a higher likelihood of chronic kidney disease, according to a review published online April 16 in...

Medically Tailored Meals Are Saving Costs in 49 States

FRIDAY, April 11, 2025 -- Medically tailored meals (MTMs) are net cost-saving in the first year in 49 states, assuming full uptake among eligible patients with diet-related...

More news resources

Subscribe to our newsletter

Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.