In order to better understand Xgeva-treated treatment-emergent hypocalcemia in patients with bone metastases, this analysis was carried out. Data from three identically designed phase 3 trials of subcutaneous Xgeva 120 mg versus intravenous zoledronic acid 4 mg were used to analyze laboratory abnormalities and hypocalcaemiarelated adverse events in patients with metastatic bone disease. Xgeva was associated with a higher overall rate of laboratory manifestations of hypocalcaemia of grade 2 than zoledronic acid. In most cases, hypocalcaemia events of grade 2 severity occurred within the first six months of treatment. Patients who revealed taking calcium as well as vitamin D enhancements had a lower rate of hypocalcaemia. Significant risk factors for developing hypocalcaemia included prostate cancer or small-cell lung cancer, decreased creatinine clearance, and elevated baseline bone turnover markers of urinary N-telopeptide of type I collagen and bone-specific alkaline phosphatase values. Patients with more than two bone metastases at baseline were more likely to be at risk for elevated BSAP levels than those with fewer than two. Xgeva had a greater antiresorptive effect than zoledronic acid, as evidenced by its higher frequency of hypocalcaemia. Before beginning treatment with a powerful osteoclast inhibitor, low serum calcium levels and potential vitamin D deficiency should be corrected, and corrected serum calcium levels should be monitored throughout treatment. The risk of hypocalcaemia appears to be significantly reduced with adequate calcium and vitamin D intake.
KeywordsMetastatic bone disease; Xgeva; Anti-resorptive effect; Zoledronic acid
Published Date: 2023-04-28; Received Date: 2023-04-01
