亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Severe Hypocalcemia With Denosumab Among Older Female Dialysis-Dependent Patients

医学 德诺苏马布 累积发病率 内科学 入射(几何) 透析 骨质疏松症 队列 肾脏疾病 回顾性队列研究 双膦酸盐 光学 物理
作者
Steven T. Bird,Elizabeth R. Smith,Kate Gelperin,Tae Hyun Jung,Aliza Thompson,Rekha Kambhampati,Hai Lyu,Henu Zhao,Yueqin Zhao,Yunfan Zhu,Olivia Easley,Ali Niak,Michael Wernecke,Yoganand Chillarige,Marina Zemskova,Jeffrey A. Kelman,David J. Graham
出处
期刊:JAMA [American Medical Association]
卷期号:331 (6): 491-491 被引量:14
标识
DOI:10.1001/jama.2023.28239
摘要

Importance Dialysis-dependent patients experience high rates of morbidity from fractures, yet little evidence is available on optimal treatment strategies. Chronic kidney disease–mineral and bone disorder is nearly universal in dialysis-dependent patients, complicating diagnosis and treatment of skeletal fragility. Objective To examine the incidence and comparative risk of severe hypocalcemia with denosumab compared with oral bisphosphonates among dialysis-dependent patients treated for osteoporosis. Design, Setting, and Participants Retrospective cohort study of female dialysis-dependent Medicare patients aged 65 years or older who initiated treatment with denosumab or oral bisphosphonates from 2013 to 2020. Clinical performance measures including monthly serum calcium were obtained through linkage to the Consolidated Renal Operations in a Web-Enabled Network database. Exposures Denosumab, 60 mg, or oral bisphosphonates. Main Outcomes and Measures Severe hypocalcemia was defined as total albumin-corrected serum calcium below 7.5 mg/dL (1.88 mmol/L) or a primary hospital or emergency department hypocalcemia diagnosis (emergent care). Very severe hypocalcemia (serum calcium below 6.5 mg/dL [1.63 mmol/L] or emergent care) was also assessed. Inverse probability of treatment-weighted cumulative incidence, weighted risk differences, and weighted risk ratios were calculated during the first 12 treatment weeks. Results In the unweighted cohorts, 607 of 1523 denosumab-treated patients and 23 of 1281 oral bisphosphonate–treated patients developed severe hypocalcemia. The 12-week weighted cumulative incidence of severe hypocalcemia was 41.1% with denosumab vs 2.0% with oral bisphosphonates (weighted risk difference, 39.1% [95% CI, 36.3%-41.9%]; weighted risk ratio, 20.7 [95% CI, 13.2-41.2]). The 12-week weighted cumulative incidence of very severe hypocalcemia was also increased with denosumab (10.9%) vs oral bisphosphonates (0.4%) (weighted risk difference, 10.5% [95% CI, 8.8%-12.0%]; weighted risk ratio, 26.4 [95% CI, 9.7-449.5]). Conclusions and Relevance Denosumab was associated with a markedly higher incidence of severe and very severe hypocalcemia in female dialysis-dependent patients aged 65 years or older compared with oral bisphosphonates. Given the complexity of diagnosing the underlying bone pathophysiology in dialysis-dependent patients, the high risk posed by denosumab in this population, and the complex strategies required to monitor and treat severe hypocalcemia, denosumab should be administered after careful patient selection and with plans for frequent monitoring.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
黄筱妍发布了新的文献求助10
15秒前
黄筱妍完成签到,获得积分20
35秒前
36秒前
39秒前
璐璐侠发布了新的文献求助10
41秒前
48秒前
璐璐侠完成签到,获得积分10
1分钟前
科研通AI2S应助科研通管家采纳,获得10
1分钟前
共享精神应助科研通管家采纳,获得10
1分钟前
1分钟前
文艺百褶裙完成签到 ,获得积分10
2分钟前
JamesPei应助小余同学采纳,获得10
2分钟前
紫熊发布了新的文献求助20
2分钟前
2分钟前
小余同学发布了新的文献求助10
2分钟前
2分钟前
mama完成签到 ,获得积分10
2分钟前
文献搬运工完成签到 ,获得积分10
2分钟前
咕咕发布了新的文献求助10
3分钟前
咕咕发布了新的文献求助10
3分钟前
MchemG应助科研通管家采纳,获得10
3分钟前
科研通AI2S应助科研通管家采纳,获得10
3分钟前
3分钟前
紫熊完成签到,获得积分10
4分钟前
4分钟前
我的文献呢完成签到 ,获得积分10
4分钟前
李爱国应助郭伟采纳,获得10
4分钟前
5分钟前
郭伟发布了新的文献求助10
5分钟前
5分钟前
5分钟前
赘婿应助科研通管家采纳,获得10
5分钟前
FashionBoy应助lty采纳,获得10
5分钟前
多亿点完成签到 ,获得积分10
5分钟前
科研通AI5应助宋雨航采纳,获得10
5分钟前
6分钟前
6分钟前
6分钟前
sowhat完成签到 ,获得积分10
6分钟前
SciGPT应助简单的雅蕊采纳,获得10
6分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968504
求助须知:如何正确求助?哪些是违规求助? 3513278
关于积分的说明 11167247
捐赠科研通 3248678
什么是DOI,文献DOI怎么找? 1794409
邀请新用户注册赠送积分活动 875030
科研通“疑难数据库(出版商)”最低求助积分说明 804638