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Incidence and predictors of hypocalcemia in end-stage renal disease patients on denosumab therapy: A systematic review and metaanalysis

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World Journal of Meta-Analysis 2024年第3期12卷 68-78页

作者： Abdul Hannan Siddiqui Misbah Shaikh Afia Salman Muham.ad Ahmed Ali Fahim Fizzah Batool Tahreem Mari Sarah Musani Muneeb Fareed Rooma Rehan am.a hassni Urooj Nizami Ayesha amir Abdul Moeed Salim R Surani Department of Internal Medicine Dow University of Health SciencesKarachi 74200SindhPakistan Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

BACKGROUND Denosumab inhibits the receptor activator of nuclear factor *** markedly increases bone mineral density and has been proven to reduce the risk of ***,numerous adverse effects,notably hypocalcemia,are prevalent in patients with end-stage renal disease(ESRD).AIM To analyze the incidence and predictors of hypocalcemia caused by denosumab compared to control in patients with *** We conducted this study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses ***,Scopus,Cochrane Central,and EMBASE were systematically searched from inception through March *** original studies investigating the effects of denosumab on patients with ESRD compared to control were *** primary outcomes of our study were the incidence of mild,severe,and very severe *** outcomes included serum levels of intact parathyroid hormone,calcium,and *** results were pooled and analyzed using a random-effects *** Seven articles comprising 3240 patients were included in our *** treated with denosumab had a significantly increased incidence of mild hypocalcemia[risk ratio(RR):2.79;95%confidence interval(CI):0.99-7.91;P=0.05;I^(2)=37%]and of very severe hypocalcemia(RR:9.58;95%CI:1.58-57.98;P=0.01;I^(2)=49%).However,an increase in the occurrence of severe hypocalcemia was non-significant(RR:4.23;95%CI:0.47-38.34;P=0.20;I^(2)=96%).Alternatively,denosumab showed a significant decrease in serum intact parathyroid hormone[mean difference(MD):-433.20,95%CI:-775.12 to-91.28,I2=98%,P=0.01],while there was a non-significant decrease in phosphate(MD:-0.47,95%CI:-1.35 to 0.41,I^(2)=88%,P=0.30)and calcium levels(MD:-0.33,95%CI:-0.95 to 0.29,I^(2)=94%,P=0.29).CONCLUSION Our study demonstrated that denosumab is significantly associated with mild and very severe hypocalcemia in patients with ESRD making it necessary to detect and prevent this side effect of treatmen

关键词： Denosumab End-stage renal disease Hypocalcemia Parathyroid hormone Dialysis

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