狄诺塞麦治疗期间要注意什么？

It is used to prevent bone-related events in patients with bone metastases from solid tumors; then, what should we pay attention to during treatment with denosumab?

1. If the patient has hypocalcemia, denosumab is prohibited.

Denosumab can significantly reduce calcium levels in the blood, and related deaths have been reported. Therefore, treat hypocalcemia before using denosumab. Take calcium and vitamin D as directed by your doctor. Tell your doctor right away if you feel cramps, twitching, cramping, muscle stiffness, numbness, or tingling in your fingers, toes, or around your mouth.

2. If the patient is allergic to denosumab, use is prohibited.

Serious allergic reactions have been reported in patients taking denosumab. If you have an allergic reaction after taking denosumab, such as low blood pressure, difficulty breathing, tightness in the throat, swelling of the face, lips, and tongue, rash, itching, and hives, please seek medical attention immediately.

3. Severe osteonecrosis of the jaw

In three clinical trials of solid tumor bone metastases, the proportion of patients who developed osteonecrosis of the jaw was 1.8% in the denosumab group versus 1.3% in the zoledronic acid group. The median time to osteonecrosis of the jaw in the denosumab group was 20.6 months. The longer you are treated with denosumab, the higher your rate of serious jaw problems.

Before starting treatment with denosumab, doctors should examine the patient's mouth. Good oral hygiene habits should be maintained while using denosumab. If you plan to have oral surgery or tooth extraction, you need to tell your doctor in advance.

4. Abnormal femur fracture

Abnormal femoral fractures have been reported in patients receiving denosumab. Symptoms include new, unusual pain in the hip, groin, or thigh.

5. The risk of hypercalcemia increases after stopping treatment

In patients with giant cell tumors of bone and those with immature bone development, there is an increased risk of hypercalcemia after discontinuation of denosumab therapy, which can be serious. Tell your doctor right away if you have symptoms of hypercalcemia, such as nausea, vomiting, headache, and decreased alertness.

6. The risk of spinal fracture increases after stopping treatment

The risk of spinal fracture increases after treatment is discontinued, especially in patients with a history of risk factors such as osteoporosis or fractures.