title: [Denosumab for bone metastasis of thoracic tumors-preparation of a practice manual and evaluation of its effectiveness].
abstract: The anti-receptor activator of nuclear factor-kB ligand (RANKL) antibody denosumab is thought to be useful in the improvement of the quality of life of patients with bone metastasis from thoracic tumors, given the ease of its subcutaneous administration. However, attention has to paid to the onset of hypocalcemia when determining the optimal dosage, especially since data and methods on its prevention are limited. Our project team monitored serum calcium levels in patients receiving denosumab treatment, evaluated methods to supplement calcium and vitamin D in cases of hypocalcemia, and developed an evidence-based common manual. Subsequently, denosumab administration and hypocalcemia were evaluated as per the manual. Grade 3 hypocalcemia was observed in 2 cases before the preparation, with no new cases seen since adopting the new protocol in the manual. We conclude that the development of severe hypocalcemia associated with denosumab treatment can be avoided by prompt management of this condition in the early stages and by adopting measures listed in the practice manual.
authors.affiliation: Dept. of Pharmacy,Osaka Prefectural Medical Center for Respiratory and Allergic Diseases.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kondo
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tamiya
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
authors.forename: Noriko
authors.initials: N
authors.lastname: Ryota
authors.forename: Masumi
authors.initials: M
authors.lastname: Sando
authors.forename: Kaori
authors.initials: K
authors.lastname: Iwata
authors.forename: Norio
authors.initials: N
authors.lastname: Okamoto
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Naoko
authors.initials: N
authors.lastname: Morishita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shiroyama
authors.forename: Sawa
authors.initials: S
authors.lastname: Takeoka
authors.forename: Akio
authors.initials: A
authors.lastname: Osa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Azuma
authors.forename: Tsunemi
authors.initials: T
authors.lastname: Tsuboi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamato
authors.forename: Kazuko
authors.initials: K
authors.lastname: Shimura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002118:Calcium / Q000097:blood; D000069448:Denosumab; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053245:RANK Ligand / Q000037:antagonists & inhibitors; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D053245:RANK Ligand; D014807:Vitamin D; D000069448:Denosumab; D002118:Calcium