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Denosumab hypocalcaemia — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsDenosumab hypocalcaemiaGPhC CRA

A 64-year-old woman with osteoporosis is due denosumab today but her calcium is 2.02 mmol/L and vitamin D level is low. She has CKD stage 3b and reports muscle cramps. What monitoring is required?

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Correct answer: B — Correct calcium and vitamin D and monitor calcium around denosumab administration

Denosumab can cause hypocalcaemia, with increased risk in renal impairment and vitamin D deficiency. Calcium and vitamin D status should be corrected and calcium monitored as clinically indicated. Symptoms such as cramps may reflect hypocalcaemia. INR and cholesterol are not the relevant safety monitoring tests.

Reference: BNF; NICE CKS