title: Calcitriol: a better option than vitamin D in denosumab-treated patients with kidney failure?
abstract: Denosumab has been proven to be at least as effective with respect to zoledronic acid in preventing skeletal-related events in patients with bone metastases from solid tumors. Although denosumab can be considered to have a more favorable toxicity profile compared to zoledronic acid in terms of kidney toxicity and flu-like symptoms, hypocalcemia is twice as frequent with denosumab. Importantly, denosumab is not metabolized by the kidney and it may be employed even in patients with severe kidney failure. Like zoledronic acid, denosumab is administered with oral calcium and vitamin D. As conversion of vitamin D to its active form is progressively impaired with a creatinine clearance < 70 ml/min, we speculate that calcitriol may be a better option than vitamin D in denosumab-treated patients with impaired kidney function.
authors.forename: Carlo
authors.initials: C
authors.lastname: Buonerba
authors.forename: Michele
authors.initials: M
authors.lastname: Caraglia
authors.forename: Simona
authors.initials: S
authors.lastname: Malgieri
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.forename: Davide
authors.initials: D
authors.lastname: Bosso
authors.forename: Piera
authors.initials: P
authors.lastname: Federico
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
authors.forename: Mimma
authors.initials: M
authors.lastname: Rizzo
authors.forename: Giovannella
authors.initials: G
authors.lastname: Palmieri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002117:Calcitriol / Q000008:administration & dosage*; D000069448:Denosumab; D006801:Humans; D053245:RANK Ligand / Q000037:antagonists & inhibitors; D051437:Renal Insufficiency / Q000188:drug therapy*; D014807:Vitamin D / Q000008:administration & dosage*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D053245:RANK Ligand; D014807:Vitamin D; D000069448:Denosumab; D002117:Calcitriol