Affiliation:
1. Department of Endocrinology The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital Beijing People's Republic of China
2. Department of Oncology The Fifth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School Beijing People's Republic of China
3. Chaoyang 1st Sanitarium for Retired Cadres of Beijing Garrison of the Chinese PLA Beijing People's Republic of China
4. Department of Nephrology The Chinese PLA Strategic Support Force Characteristic Medical Center Beijing People's Republic of China
Abstract
AbstractIntroductionThe effects of denosumab on bone mineral density (BMD) and metabolism in patients with end‐stage renal disease (ESRD) remain controversial. Hence, we performed a systematic review and meta‐analysis of observational studies.MethodsThe MEDLINE, EMBASE, and Cochrane Library databases were searched in June 2022 to identify studies that evaluated the risk of denosumab‐associated hypocalcemia and changes in bone metabolism, changes in BMD from baseline to post‐treatment in patients with ESRD.FindingsTwelve studies with 348 participants were included. The pooled incidence of hypocalcemia during denosumab treatment was 35.0% (95% confidence interval [CI], 25%–46%; I2 = 63.6%). There were no significant changes in either the serum calcium or phosphate levels from the baseline to post‐treatment period; the mean differences were 0.04 mg/dL (95% CI, −0.12 to 0.20 mg/dL) and −0.39 mg/dL (95% CI, −0.89 to 0.12 mg/dL). We found significant changes in the alkaline phosphatase and parathyroid hormone levels; the standardized mean differences were −2.98 (95% CI, −5.36 to –0.59) and −3.12 (95% CI: –4.94 to –1.29), respectively. Denosumab may increase BMD, with mean differences of 9.10% (95% CI: 4.07%–14.13%) and 9.00% (95% CI: 5.93%–12.07%) for the femoral neck and lumbar spine, respectively.DiscussionDenosumab increased the BMDs of the lumbar spine and femoral neck in patients with ESRD. The onset of hypocalcemia must be carefully monitored during denosumab administration.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Treating Osteoporosis with Denosumab in Patients on Hemodialysis;Clinical Journal of the American Society of Nephrology;2023-08-03