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Kidney Week

Abstract: SA-PO895

Efficacy of Denosumab for Dialysis Patients with Osteoporosis

Session Information

  • Mineral Disease: CKD-Bone
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

  • 1203 Mineral Disease: CKD-Bone

Authors

  • Hoshino, Junichi, Toranomon Hospital, Tokyo, Japan
  • Kunizawa, Kyohei, Toranomon Hospital, Tokyo, Japan
  • Oguro, Masahiko, Toranomon Hospital, Tokyo, Japan
  • Sekine, Akinari, Toranomon Hospital, Tokyo, Japan
  • Sumida, Keiichi, Toranomon Hospital, Tokyo, Japan
  • Yamanouchi, Masayuki, Toranomon Hospital, Tokyo, Japan
  • Ubara, Yoshifumi, Toranomon Hospital, Tokyo, Japan
Background

Osteoporosis is a major complication in patients on hemodialysis (HD) because therapeutic drugs for it are limited. Recently, the superior efficacy of denosumab—human monoclonal antibody to RANKL—in non-HD patients was reported, but evidence of its effect in HD patients remained very limited. Accordingly, we studied the safety and efficacy of denosumab in these patients.

Methods

We prospectively enrolled HD and non-HD patients who started denosumab between June 2013 to October 2015 in our hospitals, and followed them for a year. Changes in bone mineral density (BMD), serum calcium, and bone metabolic markers before and after the treatment were analyzed.

Results

In this study, 192 patients (65 HD patients, 127 non-HD patients) were enrolled. Increase of BMD in the lumbar spine among HD patients was similar to that of non-HD patients (7.1±10.7 vs 6.2±6.8 %, p=0.73), and also similar in the femoral neck (4.8±6.5 vs 3.3±7.8). On the other hand, prevalence of hypocalcemia (<8.5mg/dL) was significantly higher in HD patients than non-HD patients (32% vs 4%, p<0.001). The median duration of appearance of hypocalcemia after injection was 6 days, and change of serum calcium at day 7 was significantly lower in HD patients than in non-HD patients (-0.7±1.0 vs -0.3±0.4, p=0.03). Changes of bone metabolic markers were similar in both groups.

Conclusion

Our study suggests that denosumab was effective in HD patients, much as it was in non-HD patients. However, careful monitoring of blood tests—at least for a week—is recommended for HD patients.

Funding

  • Private Foundation Support