EJMI. 2021; 5(3): 313-316 | DOI: 10.14744/ejmi.2021.48218

Should Vitamin D Level be Measured Before Denosumab in Patients with Castration-Resistant Metastatic Prostate Cancer to Prevent Hypocalcemia?

Atike Gokcen Demiray¹, Arzu Yaren¹, Burcu Yapar Taskoylu¹, Serkan Degirmencioglu¹, Gamze Gokoz Dogu¹, Umut Cakiroglu¹, Nail Ozhan¹, Canan Karan¹, Burcin Cakan Demirel¹, Tolga Dogan¹, Melek Ozdemir^1
1Department 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 adjusting 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. Keywords: Denosumab, hypocalcemia, prostate cancer, vitamin D

---

Cite This Article

Demiray A, Yaren A, Taskoylu B, Degirmencioglu S, Dogu G, Cakiroglu U, Ozhan N, Karan C, Demirel B, Dogan T, Ozdemir M. Should Vitamin D Level be Measured Before Denosumab in Patients with Castration-Resistant Metastatic Prostate Cancer to Prevent Hypocalcemia?. EJMI. 2021; 5(3): 313-316

Corresponding Author: Atike Gokcen Demiray

Full Text PDF PDF Download