地诺单抗怎么用？

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 should denosumab be used? The following describes its recommended usage and dosage: (1) Denosumab 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 then 120 mg on d8 and d15 in the first month of treatment. (4) Administer calcium and vitamin D appropriately to prevent hypocalcemia. (5) Malignant hypercalcemia: 20 mg once every 4 weeks, subcutaneous injection, and then 120 mg on d8 and d15 in the first month of treatment. The medication is injected under the skin in the upper arm, thigh, or abdomen.

Warnings and precautions for the use of denosumab: (1) Do not use the same active drug: patients taking denosumab should not use other monoclonal antibody drugs. (2) Allergic reactions may occur when using denosumab; if allergic reactions occur, the medication should be discontinued permanently. (3) Hypocalcemia: Denosumab may cause severe symptoms of hypocalcemia, or be fatal. Hypocalcemia should be corrected before medication, and the patient's blood calcium level should be monitored during treatment, especially in the first week of first medication, and calcium and vitamin D should be supplemented appropriately. (4) Osteonecrosis of the jaw (ONJ): Osteonecrosis of the jaw (ONJ) ​​has been reported. Oral examination should be performed before medication, symptoms should be observed during treatment, and any invasive dental procedures should be avoided. (5) Atypical femoral fracture: Assess the patient’s thigh or groin pain to diagnose atypical femoral fracture. (6) Hypercalcemia after discontinuation of medication: Monitor patient’s symptoms and treat appropriately. (7) Embryo-fetal toxicity: It harms the fetus. Women of childbearing age should be informed of the dangers of this drug and take effective contraceptive measures.