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Denosumab for treatment of osteoporosis

What is Denosumab?

Denosumab is a treatment for Osteoporosis that belongs to a group of treatments called monoclonal antibodies. It makes the bones stronger by stopping the cells that break down bone.

How is it given?

Denosumab is given as a subcutaneous injection (under the skin) every 6 months. The first injection will be given to you at hospital. After a review by the specialist, future injections can be given at your GP practice.

Are there any side effects?

The most common side effects include urinary tract infections, chest infections, rashes, constipation, sciatica, limb pain and cataracts (cataracts were only reported in men using Denosumab for prostate cancer). Cellulitis (infection of the skin) and eczema are uncommon complications.

Rare side effects:

  • Osteonecrosis of the jaw (ONJ) – this means that some of the cells in the jaw die. The majority of the reported cases of ONJ followed dental procedures such as tooth extraction and many also had signs of infection around the tooth.
  • A typical (unusual) thigh bone fracture – this is a stress fracture of the middle or top of the thigh bone. These fractures are usually preceded by thigh or groin pain which is worse on standing or walking. You should consult your doctor if you experience new thigh or groin pain while on treatment.

What will happen before starting treatment?

You will have blood tests to check calcium levels, vitamin D levels and kidney function. You will then be contacted by a hospital specialist nurse who will arrange for you to attend the day unit for your first injection.

What else do I need to do?

  • Book a dental examination and carry out any planned dental procedures before starting treatment. You should inform your dentist that you are going to start treatment.
  • Keep taking your calcium and vitamin D supplements as recommended.
  • Have a blood test within 4 weeks of every injection to check your kidney function and calcium levels.
  • Inform your doctor about any new thigh or groin pain.

How long will I stay on treatment?

You will have a total course of 6 injections (3 years of treatment) and your specialist will review you at the end of your course with a repeat DEXA scan organised by your GP.

Who can not have Denosumab?

You can not have Denosumab if:

  • You are pregnant
  • You have a latex allergy
  • You are intolerant to the active substance
  • You are intolerant to fructose or any other ingredients.
  • You have a low calcium level
  • You have severe kidney disease