An Open-Label, Prospective Pilot Clinical Study of Denosumab for Severe Hyperparathyroidism in Patients With Low Bone Mass Undergoing Dialysis

Abstract

Denosumab is effective in restoring bone mass and reducing bone pain in patients on dialysis with secondary hyperparathyroidism. It also allows for a more aggressive use of calcitriol to control hyperparathyroidism.

Combination Therapy of Denosumab and Calcitriol for a Renal Transplant Recipient with Severe Bone Loss due to Therapy-Resistant Hyperparathyroidism

“…In contrast, most patients in the previously reported cases were not receiving sufficient VD treatment either before or after DMAb administration (Talreja 2012;McCormick et al 2012;Torregrosa 2013;Agarwal et al 2013;Ungprasert et al 2013;Farinola and Kanjanapan 2013). Furthermore, clinical studies by Chen et al (2014Chen et al ( , 2015 indicated that hypocalcemia was corrected shortly after adjusting Ca intake, VD dosage and Ca dialysate in HD patients with SHPT. Therefore, we consider that DMAb-induced hypocalcemia can be prevented with uptitration of the VD dosage and Ca supplementation.…”

“…Next, we address the hypocalcemia induced by DMAb in patients with CKD. Previous studies reported that hypocalcemia was the most common adverse effect of DMAb (Jamal et al 2011;Chen et al 2014). In addition, recent studies showed that treatment with DMAb induced severe hypocalcemia in CKD patients (particularly, CKD stage 4-5D patients complicated with SHPT) compared to the general population (Jamal et al 2010;Dave et al 2015).…”

“…Also, in other previously reported cases regarding DMAb therapy for CKD patients, severe hypocalcemia was observed just after administration (Talreja 2012;McCormick et al 2012;Torregrosa 2013;Agarwal et al 2013;Ungprasert et al 2013;Farinola and Kanjanapan 2013;Dusilova Sulkova et al 2014). On the other hand, rapid increase in i-PTH levels is also recognized to be associated with DMAb therapy in patients with CKD (Jamal et al 2011;Chen et al 2014;Dave et al 2015). Of note, Chen et al (2014) showed that a high i-PTH level was an important predictor of severe hypocalcemia.…”

“…On the other hand, rapid increase in i-PTH levels is also recognized to be associated with DMAb therapy in patients with CKD (Jamal et al 2011;Chen et al 2014;Dave et al 2015). Of note, Chen et al (2014) showed that a high i-PTH level was an important predictor of severe hypocalcemia. In fact, an increase in the PTH level was simultaneously observed with hypocalcemia in all reported cases, including our patient, but the increase in the PTH level was considered to be merely a compensatory response to hypocalcemia and thus biologically plausible.…”

Modern approaches to correction mineral and bone disorders in kidney transplant recipients

“…Показан хороший эффект Деносумаба в сочетании с кальцитриолом у диализных паци-ентов с тяжелым вторичным ГПТ и выраженным дефицитом минеральной костной массы [47,48]. В Японии появилось первое сообщение об успеш-ном применении Деносумаба у реципиента почеч-ного трансплантата с тяжелым рецидивирующим ГПТ, несколько раз подвергшегося хирургическим вмешательствам.…”