地舒单抗如何使用？

It is approved for the prevention of bone-related events in patients with bone metastases from solid tumors. It is not indicated for the prevention of bone-related events in patients with multiple myeloma, or for the treatment of hypercalcemia in adults or bone-mature adolescents with giant cell tumors of bone who are unresectable or surgically resectable malignancies that may cause serious complications and are bisphosphonate-resistant.

So, how to use denosumab?

(1) Desosumab can only be injected subcutaneously, not intravenously, intramuscularly or intradermally.

(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.

Adverse reactions of denosumab:

(1) The most common adverse reactions (≥25%) in patients with solid tumor bone metastasis are fatigue/asthenia, hypophosphatemia and nausea.

(2) Common adverse reactions (≥10%) in patients with giant cell tumor of bone include headache, joint pain, nausea, back pain, fatigue and limb pain.

(3) Adverse reactions of malignant hypercalcemia (≥20%) include nausea and vomiting, dyspnea, loss of appetite, headache, peripheral edema, anemia, diarrhea and constipation.

Use of denosumab in special populations:

1. Breastfeeding mothers: You should choose to stop taking the medicine or stop breastfeeding.

2. Children: It is recommended that denosumab should only be used in adolescent patients with giant cell tumor of bone who have mature bone development.

3. Patients with renal impairment: Patients whose creatinine clearance is less than 30ml/min or who undergo renal dialysis are at higher risk of hypocalcemia. Calcium and vitamin D should be appropriately supplemented during medication.

Contraindications: Contraindicated in patients with hypocalcemia and hypersensitivity to denosumab.