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  1. Article ; Online: SEVERE, PROLONGED, DENOSUMAB-INDUCED HYPOCALCEMIA WITH RECOVERY AFTER 111 DAYS OF HIGH-DOSE CALCIUM SUPPLEMENTATION.

    McCaleb, Rachael V / Johnson, Jill T

    AACE clinical case reports

    2019  Volume 5, Issue 1, Page(s) e82–e85

    Abstract: Objective: Denosumab is a monoclonal antibody commonly used for the prevention of skeletal-related events in patients with bone metastases from solid tumors. Hypocalcemia is a known adverse effect with denosumab, and we present an unusual case where 2 ... ...

    Abstract Objective: Denosumab is a monoclonal antibody commonly used for the prevention of skeletal-related events in patients with bone metastases from solid tumors. Hypocalcemia is a known adverse effect with denosumab, and we present an unusual case where 2 hypocalcemic events occurred after 1 denosumab treatment.
    Methods: A 76-year-old man recently diagnosed with prostate cancer with bone metastasis was given 120 mg denosumab subcutaneously due to extensive bone disease.
    Results: The patient experienced denosumab-induced hypocalcemia induced by a single denosumab dose which was resolved after 14 days of multiple doses of intravenous calcium gluconate and oral calcium and vitamin D replacement. However, the patient returned with acute kidney injury and severe hypocalcemia (corrected calcium of 6.9 mg/dL) without any additional dose of denosumab. The recovery following the second episode of hypocalcemia was much longer than the initial episode in this patient.
    Conclusion: To our knowledge, this is the first reported case of an additional episode of hypocalcemia following a single denosumab dose. This case highlights the importance of close monitoring of renal function and serum electrolytes following the resolution of denosumab-induced hypocalcemia.
    Language English
    Publishing date 2019-01-30
    Publishing country United States
    Document type Case Reports
    ISSN 2376-0605
    ISSN (online) 2376-0605
    DOI 10.4158/ACCR-2018-0295
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical Outcomes of Acid Suppressive Therapy Use in Hematology/Oncology Patients at an Academic Medical Center.

    McCaleb, Rachael V / Gandhi, Arpita S / Clark, Stephen Michael / Clemmons, Amber B

    The Annals of pharmacotherapy

    2016  Volume 50, Issue 7, Page(s) 541–547

    Abstract: Background: Acid suppressive therapy (AST)-namely, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (SUP).: Objective: To identify the incidence ... ...

    Abstract Background: Acid suppressive therapy (AST)-namely, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (SUP).
    Objective: To identify the incidence of and indications for AST use in the hematology/oncology population as well as to identify the occurrence of the following PPI-associated adverse events: pneumonia and Clostridium difficile-associated diarrhea (CDAD).
    Methods: A retrospective chart review was conducted on adult hematology/oncology patients admitted to any oncology service for ≥48 hours from October 1, 2014, to December 31, 2014.
    Results: Of the 298 patients who met the inclusion criteria, 73% (n = 218) received an AST during admission. The most common indication for an AST was SUP (63%). The incidence of hospital-acquired pneumonia (HAP) was 10%, 0%, and 4% in patients who received a PPI, H2RA, and no AST, respectively (14/142 vs 0/70 vs 3/80; odds ratio [OR] for PPI vs no AST = 2.68; 95% CI = 0.75-9.63). The incidence of CDAD was 3%, 1.3%, and 1.2% in patients who received a PPI, H2RA, and no AST, respectively (4/142 vs 1/70 vs 1/80; OR for PPI vs H2RA = 1.92; 95% CI = 0.21-17.47).
    Conclusion: This is the first study to describe the incidence of and indications for AST use in the hospitalized hematology/oncology population. There was a high occurrence of AST use, particularly PPIs, in these patients at our institution. Additionally, there was a trend toward an increased risk of HAP and CDAD in patients who received AST during admission.
    MeSH term(s) Academic Medical Centers/statistics & numerical data ; Adult ; Clostridium difficile/isolation & purification ; Cross Infection/epidemiology ; Diarrhea/chemically induced ; Diarrhea/epidemiology ; Diarrhea/microbiology ; Drug Utilization Review/statistics & numerical data ; Female ; Hematologic Diseases/complications ; Hematologic Diseases/drug therapy ; Histamine H2 Antagonists/administration & dosage ; Histamine H2 Antagonists/adverse effects ; Histamine H2 Antagonists/therapeutic use ; Hospitalization ; Humans ; Incidence ; Male ; Medical Records ; Middle Aged ; Neoplasms/complications ; Neoplasms/drug therapy ; Odds Ratio ; Peptic Ulcer/epidemiology ; Peptic Ulcer/prevention & control ; Pneumonia/chemically induced ; Pneumonia/epidemiology ; Proton Pump Inhibitors/administration & dosage ; Proton Pump Inhibitors/adverse effects ; Proton Pump Inhibitors/therapeutic use ; Retrospective Studies ; Risk Factors
    Chemical Substances Histamine H2 Antagonists ; Proton Pump Inhibitors
    Language English
    Publishing date 2016-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1101370-9
    ISSN 1542-6270 ; 1060-0280
    ISSN (online) 1542-6270
    ISSN 1060-0280
    DOI 10.1177/1060028016644469
    Database MEDical Literature Analysis and Retrieval System OnLINE

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