地诺单抗要注意什么？

(Xgeva) is a drug used to treat cancer bone metastases. Which is most commonly used in our breast cancer patients with bone metastases. What should patients pay attention to when using denosumab?

The first thing we need to understand is the injection method and dosage of denosumab. It is administered subcutaneously in the upper arm, upper thigh, or abdomen at 120/mg once every 4 weeks.

Hypocalcemia must be corrected before denosumab therapy can be initiated. 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), clinical monitoring of creatinine and mineral levels is required, and such patients should be instructed to pay attention to the symptoms of hypocalcemia and to supplement adequate amounts of calcium and vitamin D. Patients who are concurrently taking immunosuppressants or have compromised immune systems may be at increased risk of serious infections, and physicians need to fully consider the benefit-risk ratio before prescribing denosumab to such patients. Physicians should evaluate the need to continue denosumab therapy 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 denosumab treatment, and good oral hygiene should be maintained after treatment is started. If a patient develops osteonecrosis of the jaw, treatment for osteonecrosis of the jaw may worsen the condition, and discontinuation of the medication should be considered at this time.

Allergic reactions may occur during use; if allergic reactions occur, use should be discontinued permanently. Hypocalcemia: Denosumab may cause severe symptoms of hypocalcemia, which may be fatal. Atypical femoral fracture: Assess the patient for thigh or groin pain to diagnose atypical femoral fracture. Hypercalcemia after discontinuation: Monitor patients for symptoms and treat appropriately. Embryo-fetal toxicity: Denosumab is harmful to the fetus. Women of childbearing age should be informed of the dangers of this drug and take effective contraceptive measures.