Since denosumab-associated hypocalcemia occurs infrequently, data on its incidence and risk factors are limited. We aimed to evaluate risk factors and develop a useful score for identifying individuals at risk of denosumab-associated hypocalcemia. In this retrospective cohort, 790 consecutive female patients who received 60 mg denosumab at least once between 2016 and 2017 were analyzed. Based on biochemical records from a large-scale single-center, mild and moderate hypocalcemia were defined as albumin-corrected calcium (cCa) levels < 8.5 and < 8.0 mg/dL (< 2.12 and < 2.0 mmol/L), respectively. Mild and moderate hypocalcemia were observed in 8.2% and 1.0% patients, respectively. Patients who developed mild hypocalcemia had lower baseline cCa (8.9 vs. 9.3 mg/dL and 2.22 vs. 2.32mmo/L) and estimated glomerular filtration rate (75.0 vs. 83.2 mL/min/1.73 m²) and more frequent loop diuretic use (10.8% vs. 4.4%; all p < 0.05). In multivariate analysis, low baseline cCa (OR 1.29; 95% CI 1.20–1.40) and chronic kidney disease (CKD) stages 3b-5 were associated with elevated mild hypocalcemia risk (OR 2.92; 95% CI 1.38–6.20). Loop diuretics use was associated with mild hypocalcemia (OR 2.61; 95% CI 1.11–6.18) by univariate analysis, independent of baseline cCa and CKD stage. A scoring approach identified two risk groups: (1) patients without CKD (eGFR ≥ 45) and cCa < 8.5 mg/dL (2.12 mmol/L) and (2) patients with CKD (eGFR < 45) and cCa < 9.5 mg/dL (2.37 mmol/L).

由于与地诺单抗相关的低钙血症很少发生，因此有关其发生率和危险因素的数据有限。我们旨在评估危险因素并开发有用的评分，以识别处于与地诺单抗相关的低血钙症风险中的个体。在此回顾性队列中，分析了2016年至2017年间790例连续接受至少60 mg地诺单抗的女性患者。根据大规模单中心的生化记录，轻度和中度低钙血症定义为白蛋白校正的钙（cCa）水平分别为<8.5和<8.0 mg / dL（<2.12和<2.0 mmol / L）。分别在8.2％和1.0％的患者中观察到轻度和中度低钙血症。发生轻度低钙血症的患者的基线cCa较低（8.9 vs. 9.3 mg / dL，2.22 vs. 2.32mmo / L），估计的肾小球滤过率（75.0 vs. 9.3 mg / dL）。²）和更频繁使用loop利尿剂（10.8％vs. 4.4％；所有p  <0.05）。在多变量分析中，低基线cCa（OR 1.29； 95％CI 1.20-1.40）和慢性肾脏病（CKD）3b-5期与轻度低血钙风险增加相关（OR 2.92； 95％CI 1.38-6.20）。通过单变量分析，使用利尿剂与轻度低钙血症（OR 2.61； 95％CI 1.11–6.18）相关，与基线cCa和CKD阶段无关。评分方法确定了两个风险组：（1）没有CKD（eGFR≥45）和cCa <8.5 mg / dL（2.12 mmol / L）的患者和（2）CKD（eGFR <45）和cCa <9.5 mg / d的患者dL（2.37 mmol / L）。