地舒单抗的作用功效和效果

Introduction: Denosumab is a humanized monoclonal antibody that specifically inhibits RANKL (receptor-activated nuclear factor-κB ligand). Denosumab binds RANKL, blocks its binding to RANK, reduces the number and activity of osteoclasts, thereby slowing down bone loss and destruction, and achieving the effect of protecting bones. Desosumab is indicated for the prevention of bone-related events in patients with bone metastases from solid tumors and in patients with multiple myeloma, and for the treatment of giant cell tumors of bone that are unresectable or in which surgical resection may result in severe functional disability.

Efficacy of denosumab

Denosumab is mainly used to prevent and treat bone-related events (SREs) in patients with solid tumor bone metastases and multiple myeloma, such as bone pain, pathological fractures, hypercalcemia, etc. By reducing the activity of osteoclasts, denosumab helps protect bones, reduce the risk of fractures, and improve patients' quality of life. It can improve the bone microenvironment, reduce the attraction of bones to tumor cells, and improve the efficacy of immunotherapy. In the treatment of bone metastases, denosumab can help delay the onset of pain and reduce the patient's need for analgesic medications.

Therapeutic efficacy of denosumab

Denosumab (60 mg subcutaneously every six months) has been tested for its effectiveness in reducing osteoporotic fractures in two multicenter, double-blind, randomized, placebo-controlled studies. Among 734 men (average age 75.3) who received antiandrogen therapy for prostate cancer, bone density increased by 5.6% after two years, while bone density decreased by 1.0% in the placebo group. Vertebral fractures occurred in 1.5% of patients compared with 3.9% in the placebo group (62% relative risk reduction).

The second study (the "FREEDOM trial") included 7868 postmenopausal women aged 60 to 69 years with osteoporosis. The rate of vertebral fracture over 36 months was 2.3% versus 7.2% in the placebo group (68% relative risk reduction). The incidence of femoral shaft fractures was 0.7% in the placebo group compared with 1.2% in the placebo group (40% relative risk reduction).

Monitoring during denosumab treatment

After treatment, changes in bone turnover rate can be assessed by detecting bone turnover markers in serum, such as serum type I collagen carboxyl terminal peptide cross-linking (CTX). The decrease in CTX levels after treatment can be used as an indicator of efficacy. It is recommended to measure the baseline value of BMD (bone mineral density) before starting treatment, and to measure BTM again at 1 month and 3 to 6 months after treatment to understand the treatment response, and then measure BMD once a year to monitor the efficacy. Because denosumab may cause hypocalcemia, it is recommended to monitor serum calcium levels before each dose and for 2 weeks after the first dose in patients prone to hypocalcemia.

Patients should work closely with medical professionals, conduct necessary examinations according to the doctor's recommendations, and adjust treatment plans based on the examination results. Adjust daily diet appropriately during denosumab treatment to ensure adequate calcium intake to support bone health and reduce the risk of hypocalcemia. It is important to note that any dietary or supplement modifications should be made under the guidance of a medical professional.