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Temporal Artery Ultrasound GCA — SCE Rheumatology MCQ

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HardMusculoskeletal ImagingTemporal Artery Ultrasound GCASCE Rheumatology

A dialysis patient with severe osteoporosis is selected for denosumab after specialist review. Corrected calcium is normal after supplementation. Which statement about renal impairment is accurate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Use 60 mg six-monthly with intensified calcium supplementation and monitoring

Explanation lettering: D = shown as B · B = shown as D

B is correct. Denosumab does not require renal dose adjustment, including in advanced renal impairment, but CrCl below 30 mL/min and dialysis markedly increase the risk of severe hypocalcaemia and secondary PTH elevation. Calcium and vitamin D must be adequate, calcium is checked before every dose, and predisposed patients require early post-initial-dose monitoring. A lower dose or longer interval is not an authorised renal strategy.

Reference: Prolia 60 mg solution for injection SmPC: https://www.medicines.org.uk/emc/product/568/smpc