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( 6 , 7 ). The data on the efficacy and safety of denosumab led to its approval for postmenopausal osteoporosis, skeletal complications and hypercalcemia of malignancies. In case of postmenopausal osteoporosis denosumab reduces the risk of vertebral
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effects have been reported in patients with LCH treated with bisphosphonates ( 60 ). Novel treatment approaches Denosumab, an antibody targeting RANKL, has been used as a treatment in osteoporosis and has recently been approved for diminishing the
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are bisphosphonates, denosumab or selective estrogen receptor modulators (SERMs) ( 13 ). However, these compounds may have side effects. Both short-term (e.g. hypocalcemia or ocular inflammation) and long-term (e.g. osteonecrosis or atrial fibrillation
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form of bone-directed therapy: 50% received a form of radiation, 45% received a bisphosphonate, 18% underwent surgical resection, 13% received 131 I-MIBG, and 5% received denosumab. Moreover, 46% were treated with more than one treatment modality
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reduction is temporary. Denosumab came to market in 2010 as the first novel agent in 30 years targeted at inhibiting bone resorption. It is a human MAB that binds to and inhibits the receptor activator of nuclear factor kappa-B ligand (RANKL), the primary
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Department of Renal Physiology, Necker Hospital, Université de Paris, Paris, France
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treatment of CKD stage 4–5D patients with osteoporosis, that is, low bone mass or fractures remained a challenge. A more recent drug offered new opportunities. Denosumab at the dose of 60 mg prescribed for the prevention of fracture in patients at high risk
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Calcimimetics, denosumab, calcitonin Under specialist supervision Can be considered if poor response to other measures Parathyroidectomy Can be considered in acute presentation of primary hyperparathyroidism if severe hypercalcaemia and poor
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, both alone and in association with local radiotherapy (23% in synchronous and 24% in metachronous). In our series, few patients are treated with denosumab or orthopedic corset (data not shown). The skeletal-related events (pathological fractures or
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Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, Missouri, USA
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regarding non-vertebral fractures (reviewed in 176 ). Thus, even though bisphosphonate further suppress bone turnover, they may still be an effective therapy for patients with T2DM. Denosumab Denosumab is a monoclonal antibody targeted against RANKL
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Department of Medicine, National University Hospital, Singapore
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Department of Medicine, National University Hospital, Singapore
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dose was 43.4 mg with most patients maintained at 25–50 mg per day. Twenty-six with bisphosphonates, denosumab or estrogen receptor modulators 6 Koman et al . 2019 Retrospective 101/110 62 PHPT Patients were started with 30 mg of