Denosumab-induced hypocalcaemia in metastatic gastric cancer

BMJ Support Palliat Care. 2020 Aug 27:bmjspcare-2020-002548. doi: 10.1136/bmjspcare-2020-002548. Online ahead of print.

Abstract

Hypocalcaemia in malignancy is infrequently reported and the underlying cause is often multifactorial. Denosumab, an antiresorptive medication, can be used to treat a number of cancer-related complications including hypercalcaemia, metastatic bone pain and to reduce fracture-events. We present a case of a hospice inpatient with profound and recurring hypocalcaemia following a single denosumab infusion which required repeated hospitalisation, for intravenous calcium, alongside a prolonged course of vitamin D and electrolyte replacement. The case highlights the risk of hypocalcaemia with denosumab use, together with the need to identify and treat vitamin D deficiency in both the prevention and management of such a complication.

Keywords: drug administration; gastrointestinal (upper); hospice care; pain; pharmacology.