Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis
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 F...
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| Veröffentlicht in: | Scientific reports 2021-01, Vol.11 (1), p.978-978, Article 978 |
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| creator | Kanbayashi, Yuko Sakaguchi, Koichi Hongo, Fumiya Ishikawa, Takeshi Tabuchi, Yusuke Ukimura, Osamu Takayama, Koichi Taguchi, Tetsuya |
| description | 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
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| doi_str_mv | 10.1038/s41598-020-80243-y |
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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.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-80243-y</identifier><identifier>PMID: 33441770</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/174 ; 692/4028/67 ; 692/499 ; Bone cancer ; Calcium ; Calcium (blood) ; Dexamethasone ; Hemoglobin ; Humanities and Social Sciences ; Hypocalcemia ; Immunotherapy ; Metastases ; Monoclonal antibodies ; multidisciplinary ; Patients ; Regression analysis ; Science ; Science (multidisciplinary) ; Targeted cancer therapy ; Vitamin D</subject><ispartof>Scientific reports, 2021-01, Vol.11 (1), p.978-978, Article 978</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-510e2576983434b435f947bbdfa7851b52bc089c266a4cf6c09b38fa390913913</citedby><cites>FETCH-LOGICAL-c540t-510e2576983434b435f947bbdfa7851b52bc089c266a4cf6c09b38fa390913913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806964/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806964/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,27911,27912,41107,42176,51563,53778,53780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33441770$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kanbayashi, Yuko</creatorcontrib><creatorcontrib>Sakaguchi, Koichi</creatorcontrib><creatorcontrib>Hongo, Fumiya</creatorcontrib><creatorcontrib>Ishikawa, Takeshi</creatorcontrib><creatorcontrib>Tabuchi, Yusuke</creatorcontrib><creatorcontrib>Ukimura, Osamu</creatorcontrib><creatorcontrib>Takayama, Koichi</creatorcontrib><creatorcontrib>Taguchi, Tetsuya</creatorcontrib><title>Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>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.</description><subject>692/308/174</subject><subject>692/4028/67</subject><subject>692/499</subject><subject>Bone cancer</subject><subject>Calcium</subject><subject>Calcium (blood)</subject><subject>Dexamethasone</subject><subject>Hemoglobin</subject><subject>Humanities and Social Sciences</subject><subject>Hypocalcemia</subject><subject>Immunotherapy</subject><subject>Metastases</subject><subject>Monoclonal antibodies</subject><subject>multidisciplinary</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Targeted cancer therapy</subject><subject>Vitamin D</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNp9kk1v1DAQhiMEolXpH-CALHHhEnD8kdgXJFRBW6kSHOBsTZzJrleJvdhJq_wTfi7eTSktB6yR_PXOM2PrLYrXFX1fUa4-JFFJrUrKaKkoE7xcnhWnjApZMs7Y80frk-I8pR3NQzItKv2yOOFciKpp6Gnx61vEztkpxET6EEmHtziE_Yh-IqHPWx_SPEJbOt_NFjuyXfbBwmABRwfEeWLBW4xkD5PLSYncuWlL2uCRjDhByoEpcyaMo_MZ0C4kxA5zWTKEjUuTsyTiJmJKLngCHoYlufSqeNHDkPD8fj4rfnz5_P3iqrz5enl98emmtFLQqZQVRSabWisuuGgFl70WTdt2PTRKVq1kraVKW1bXIGxfW6pbrnrgmuqK5zgrrlduF2Bn9tGNEBcTwJnjQYgbAzH3OKDhkgMI1WvbKNFZVHXXSCuVYiLXBppZH1fWfm5HzAo_RRieQJ_eeLc1m3BrGkVrXYsMeHcPiOHnjGkyo0sWhwE8hjkZJrKSayUOfb_9R7oLc8yfd1Q1XFHJDx2xVWVjSCli_9BMRc3BR2b1kck-MkcfmSUnvXn8jIeUP67JAr4KUr7yG4x_a_8H-xtKZ9b-</recordid><startdate>20210113</startdate><enddate>20210113</enddate><creator>Kanbayashi, Yuko</creator><creator>Sakaguchi, Koichi</creator><creator>Hongo, Fumiya</creator><creator>Ishikawa, Takeshi</creator><creator>Tabuchi, Yusuke</creator><creator>Ukimura, Osamu</creator><creator>Takayama, Koichi</creator><creator>Taguchi, Tetsuya</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><general>Nature Portfolio</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20210113</creationdate><title>Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis</title><author>Kanbayashi, Yuko ; 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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.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>33441770</pmid><doi>10.1038/s41598-020-80243-y</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 692/308/174 692/4028/67 692/499 Bone cancer Calcium Calcium (blood) Dexamethasone Hemoglobin Humanities and Social Sciences Hypocalcemia Immunotherapy Metastases Monoclonal antibodies multidisciplinary Patients Regression analysis Science Science (multidisciplinary) Targeted cancer therapy Vitamin D |
| title | Predictors for development of denosumab-induced hypocalcaemia in cancer patients with bone metastases determined by ordered logistic regression analysis |
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