Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis
Abstract This retrospective study was undertaken to identify predictors for the development of hypocalcaemia even with prophylactic administration of calcium and vitamin D, and to help guide future strategies to improve the safety, efficacy, and QOL of patients receiving denosumab. Between January 2...
Guardado en:
| Autores principales: | , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Nature Portfolio
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/353aa48f9c784dce86d75c58824434a0 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:353aa48f9c784dce86d75c58824434a0 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:353aa48f9c784dce86d75c58824434a02021-12-02T14:01:36ZPredictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis10.1038/s41598-020-80243-y2045-2322https://doaj.org/article/353aa48f9c784dce86d75c58824434a02021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80243-yhttps://doaj.org/toc/2045-2322Abstract This retrospective study was undertaken to identify predictors for the development of hypocalcaemia even with prophylactic administration of calcium and vitamin D, and to help guide future strategies to improve the safety, efficacy, and QOL of patients receiving denosumab. Between January 2016 and February 2020, a total of 327 advanced cancer patients at our hospital who were receiving denosumab were enrolled. Variables associated with the development of hypocalcaemia were extracted from the clinical records. The level of hypocalcaemia was evaluated using CTCAE version 5. Multivariate ordered logistic regression analysis was performed to identify predictors for the development of hypocalcaemia. Optimal cut off thresholds were determined using ROC analysis. Values of P < 0.05 (2-tailed) were considered significant. 54 patients have developed hypocalcemia (≥ Grade 1). Significant factors identified included concomitant use of vonoprazan [odds ratio (OR) = 3.74, 95% confidence interval (CI) 1.14–12.26; P = 0.030], dexamethasone (OR = 2.45, 95%CI 1.14–5.42; P = 0.022), pre-treatment levels of serum calcium (OR = 0.27, 95%CI 0.13–0.54; P < 0.001), ALP/100 (OR = 1.04, 95%CI 1.01–1.07; P = 0.003), and haemoglobin (OR = 0.79, 95%CI 0.68–0.93; P = 0.004). ROC curve analysis revealed that the threshold for pre-treatment levels of serum calcium was ≤ 9.3 mg/dL, ALP was ≥ 457 U/L, and haemoglobin was ≤ 10.4 g/dL. In conclusion, concomitant use of vonoprazan or dexamethasone, and pre-treatment levels of serum calcium (low), ALP (high) and haemoglobin (low) were identified as significant predictors for the development of denosumab-induced hypocalcaemia.Yuko KanbayashiKoichi SakaguchiFumiya HongoTakeshi IshikawaYusuke TabuchiOsamu UkimuraKoichi TakayamaTetsuya TaguchiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Yuko Kanbayashi Koichi Sakaguchi Fumiya Hongo Takeshi Ishikawa Yusuke Tabuchi Osamu Ukimura Koichi Takayama Tetsuya Taguchi Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| description |
Abstract This retrospective study was undertaken to identify predictors for the development of hypocalcaemia even with prophylactic administration of calcium and vitamin D, and to help guide future strategies to improve the safety, efficacy, and QOL of patients receiving denosumab. Between January 2016 and February 2020, a total of 327 advanced cancer patients at our hospital who were receiving denosumab were enrolled. Variables associated with the development of hypocalcaemia were extracted from the clinical records. The level of hypocalcaemia was evaluated using CTCAE version 5. Multivariate ordered logistic regression analysis was performed to identify predictors for the development of hypocalcaemia. Optimal cut off thresholds were determined using ROC analysis. Values of P < 0.05 (2-tailed) were considered significant. 54 patients have developed hypocalcemia (≥ Grade 1). Significant factors identified included concomitant use of vonoprazan [odds ratio (OR) = 3.74, 95% confidence interval (CI) 1.14–12.26; P = 0.030], dexamethasone (OR = 2.45, 95%CI 1.14–5.42; P = 0.022), pre-treatment levels of serum calcium (OR = 0.27, 95%CI 0.13–0.54; P < 0.001), ALP/100 (OR = 1.04, 95%CI 1.01–1.07; P = 0.003), and haemoglobin (OR = 0.79, 95%CI 0.68–0.93; P = 0.004). ROC curve analysis revealed that the threshold for pre-treatment levels of serum calcium was ≤ 9.3 mg/dL, ALP was ≥ 457 U/L, and haemoglobin was ≤ 10.4 g/dL. In conclusion, concomitant use of vonoprazan or dexamethasone, and pre-treatment levels of serum calcium (low), ALP (high) and haemoglobin (low) were identified as significant predictors for the development of denosumab-induced hypocalcaemia. |
| format |
article |
| author |
Yuko Kanbayashi Koichi Sakaguchi Fumiya Hongo Takeshi Ishikawa Yusuke Tabuchi Osamu Ukimura Koichi Takayama Tetsuya Taguchi |
| author_facet |
Yuko Kanbayashi Koichi Sakaguchi Fumiya Hongo Takeshi Ishikawa Yusuke Tabuchi Osamu Ukimura Koichi Takayama Tetsuya Taguchi |
| author_sort |
Yuko Kanbayashi |
| title |
Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| title_short |
Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| title_full |
Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| title_fullStr |
Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| title_full_unstemmed |
Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| title_sort |
predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/353aa48f9c784dce86d75c58824434a0 |
| work_keys_str_mv |
AT yukokanbayashi predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT koichisakaguchi predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT fumiyahongo predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT takeshiishikawa predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT yusuketabuchi predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT osamuukimura predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT koichitakayama predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis AT tetsuyataguchi predictorsfordevelopmentofdenosumabinducedhypocalcaemiaincancerpatientswithbonemetastasesdeterminedbyorderedlogisticregressionanalysis |
| _version_ |
1718392132269506560 |