狄诺塞麦注意事项有什么？

(denosumab, also known as AMG-162, trade name Prolia) is a bone resorption inhibitor with a unique mechanism of action. It specifically targets receptor activator of nuclear factor kappa B (RANK) ligand, inhibits the activation and development of osteoclasts, reduces bone resorption, and increases bone density. On May 28, 2010, the European Commission approved denosumab for the treatment of bone loss associated with hormone suppression in postmenopausal women with osteoporosis and prostate cancer. It can also be used in patients who are currently ineffective or intolerant to other treatments to reduce the risk of fractures. Denosumab (desosumab) was approved for the first time in 27 EU member states, as well as Norway, Iceland, and Liechtenstein. In June of the same year, denosumab was approved by the FDA.

In addition, denosumab is a drug that targets the RANK ligand. Compared with the bisphosphonates that have been used clinically, denosumab has the advantage of significantly prolonging the occurrence time of bone damage-related events. It can be administered subcutaneously and is easy to use. Clinical data shows that the drug does not require monitoring of renal function, while the use of bisphosphonates does. The dosing speed is determined based on the patient's renal function monitoring; however, denosumab is currently relatively expensive, and the balance between its long-term efficacy and cost-effectiveness needs to be further confirmed. It is expected that denosumab, a drug specifically targeting RANK ligand inhibitors, can obtain more valuable research results in the treatment of solid tumors and bring new hope to patients with bone metastasis. Therefore, for patients who are prone to hypocalcemia and mineral metabolism imbalance (such as those with a history of hypoparathyroidism, thyroid surgery, parathyroid surgery, malnutrition, small bowel resection, severe renal insufficiency), it is necessary to closely monitor their creatinine and mineral levels in clinical practice, and instruct such patients to pay attention to the symptoms of hypocalcemia and to supplement adequate amounts of calcium and vitamin D.

Patients who are also taking immunosuppressants or whose immune systems are compromised may be at increased risk of serious infections. Physicians must fully consider the benefit and risk ratio before prescribing denosumab (desosumab) to such patients. Physicians should evaluate the need to continue treatment with denosumab (desosumab) in patients who develop serious infections while taking denosumab. Osteonecrosis of the jaw often occurs with tooth extraction and local infection that delays healing. A routine oral examination should be performed before starting treatment with denosumab, and good oral hygiene should be maintained after treatment is started. If patients develop osteonecrosis of the jaw after taking it, treatment for the osteonecrosis of the jaw may worsen the condition, and discontinuation of the drug should be considered at this time.