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ADR Yönetimi

SHOULD VITAMIN D LEVEL BE MEASURED BEFORE DENOSUMAB IN PATIENTS WITH CASTRATION-RESISTANT METASTATIC PROSTATE CANCER TO PREVENT HYPOCALCEMIA?

ATİKE GOKCEN DEMİRAY, ARZU YAREN, BURCU YAPAR TASKOYLU, SERKAN DEGİRMENCİOGLU, GAMZE GOKOZ DOGU, UMUT CAKİROGLU, NAİL OZHAN, CANAN KARAN, BURCİN CAKAN DEMİREL, TOLGA DOGAN, MELEK OZDEMİR

Eurasian Journal of Medical Investigation - 2021;5(3):313-316

Department of Medical Oncology, Pamukkale University Faculty of Medicine, Denizli, Turkey

 

Objectives: Denosumab reduces skeletal related events in castration-resistant metastatic prostate cancer (CRMPC) with bone metastases.It is recommended to give calcium and vitamin D to prevent hypocalcemia after denosumab. There is no recommendation to check vitamin D and the specific level of vitamin D that should not be given before denosumab. We aimed to show that the rate of hypocalcemia is high even in vitamin D deficiency alone in the absence of other risk factors for hypocalcemia and can be reduced by checking vitamin D before the administration or by adjust ing the dose of denosumab according to the vitamin D, which are not included in denosumab product information (PI). Methods: We retrospectively analyzed 40 CRMPC patients who received subcutaneous injections of 120 mg denosumab. Results: 28 patients had vitamin D deficiency before treatment. Patients with vitamin D deficiency had a higher rate of hypocalcemia (87.5% vs 16.6%). Hypocalcemia was significantly higher in patients with vitamin D deficiency (p:0.001). In patients with vitamin D deficiency, 87.5% grade1, 8.3% grade 2 and 4.1% grade 3 hypocalcemia developed. Conclusion: Vitamin D should be checked before treatment to prevent denosumab-related hypocalcemia. New studies should be planned for this recommendation to be in the denosumab PI.