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Denosumab (also known as denosumab, English name: Denosumab) is a RANK ligand (RANKL) inhibitor with a different mechanism of action from currently approved drugs that reduce skeletal complications of tumors. It is a fully humanized monoclonal antibody (IgG2 monoclonal antibody) that specifically targets receptor activator of nuclear factor-κB ligand (RANKL). It prevents RANKL from binding to its receptor substances, inhibits osteoclast activation and development, reduces bone resorption, and increases bone density. What is the specific usage and dosage of denosumab?

(1) Denosumab (Denosumab) can only be administered by subcutaneous injection, not intravenous infusion, intramuscular infusion or intradermal injection.

(2) Solid tumor bone metastasis: 120mg once every 4 weeks, injected subcutaneously in the upper arm, thigh or abdomen.

(3) Giant cell tumor of bone: 120 mg once every 4 weeks, subcutaneous injection, and another 120 mg on day 8 and day 15 in the first month of treatment.

(4) Administer calcium and vitamin D appropriately to prevent hypocalcemia.

(5) Malignant hypercalcemia: 120 mg once every 4 weeks, subcutaneous injection, and another 120 mg on day 8 and day 15 in the first month of treatment. The medication is injected under the skin in the upper arm, thigh, or abdomen.

Denosumab (Denosumab) adverse drug reactions

The most common adverse reactions in patients with bone metastases from solid tumors include: weakness/fatigue, nausea, and hypophosphatemia.

Common adverse reactions in patients with giant cell tumor of bone include joint pain, headache, back pain, nausea, limb pain, and fatigue.

Precautions when taking denosumab

1. Osteonecrosis of the jaw may occur in patients receiving denosumab. Perform an oral examination before starting denosumab, monitor symptoms, and avoid invasive dental procedures during treatment.

2. Patients receiving denosumab may develop hypocalcemia and severe hypocalcemia. Calcemia should be corrected before starting medication, and calcium levels should be monitored and all patients appropriately supplemented with calcium and vitamin D.