Zhao Yihan, Zhang Fang, Zhang Simin, Zhang Xiaona, Gao Leili, Ren Qian, Han Xueyao, Ji Linong
Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
Horm Metab Res. 2024 Dec;56(12):839-844. doi: 10.1055/a-2411-9426. Epub 2024 Oct 11.
Denosumab is a completely human monoclonal high-affinity antibody that binds to the nuclear factor kappa-B ligand (RANKL) and is widely used to treat osteoporosis. Furthermore, it can potentially lower serum calcium levels by inhibiting osteoclast activation and preventing bone calcium from being released into the blood. This review aimed to provide evidence of the efficacy and safety of denosumab in treating hypercalcemia in primary hyperparathyroidism (PHPT). PubMed and the Cochrane Library were searched for published studies that described denosumab for hypercalcemia management in PHPT. Data were extracted by two independent investigators and analyzed using SPSS 23. The risk of bias was assessed by NIH Quality Assessment Tool. In total, 161 patients with PHPT from 18 studies were included in this review. The average age was 61 (47-72) years and the highest serum calcium was 3.76 (3.11-4.20) mmol/l. We found that denosumab can effectively reduce the serum calcium level by a median reduction of 0.5 mmol/l within 3 days. Significant reduction was maintained for 14 days. The serum calcium-lowering effect weakened after one month. In conclusion, denosumab has a potential clinical value in treating hypercalcemia in patients with PHPT.
地诺单抗是一种完全人源化的单克隆高亲和力抗体，可与核因子κB配体（RANKL）结合，广泛用于治疗骨质疏松症。此外，它可能通过抑制破骨细胞活化并防止骨钙释放到血液中从而降低血清钙水平。本综述旨在提供地诺单抗治疗原发性甲状旁腺功能亢进症（PHPT）患者高钙血症的疗效和安全性证据。检索了PubMed和Cochrane图书馆中已发表的描述地诺单抗用于PHPT高钙血症管理的研究。由两名独立研究人员提取数据并使用SPSS 23进行分析。采用美国国立卫生研究院质量评估工具评估偏倚风险。本综述共纳入了来自18项研究的161例PHPT患者。平均年龄为61（47 - 72）岁，最高血清钙为3.76（3.11 - 4.20）mmol/l。我们发现，地诺单抗可在3天内有效降低血清钙水平，中位数降低0.5 mmol/l。显著降低持续14天。一个月后血清降钙效果减弱。总之，地诺单抗在治疗PHPT患者高钙血症方面具有潜在的临床价值。
