Denosumab steroid induced osteoporosis

Vitamin D comes from the diet and the skin. Vitamin D production by the skin is dependent on exposure to sunlight. Active people living in sunny regions (Southern California, Hawaii, countries around the equator, etc.) can produce most of the vitamin D they need in their skin. Conversely, lack of exposure to sunlight, due to residence in northern latitudes or physical incapacitation, causes vitamin D deficiency. In less temperate regions such as Minnesota, Michigan, and New York, production of vitamin D by the skin is markedly diminished in the winter months, especially among the elderly. In that population, dietary vitamin D becomes more important.

It is indicated to increase bone mass in men [ 164 ] and postmenopausal women with osteoporosis who are at high risk of fracture (defined as a history of osteoporotic fracture), have multiple risk factors for fracture, are intolerant to other available osteoporosis therapies, or in whom osteoporosis therapies have failed. In postmenopausal women with osteoporosis, denosumab reduces the incidence of vertebral, nonvertebral, and hip fractures. Denosumab may be considered in certain patients with renal insufficiency, as impaired renal function does not significantly affect the metabolism or excretion of the drug. [ 165 ]

60 mg/m2 orally daily on days 1, 2, 3, and 4; bortezomib mg/m2 subcutaneously twice weekly on weeks 1, 2, 4, and 5 of cycle 1 followed by bortezomib mg/m2 subcutaneously once weekly on weeks 1, 2, 4, and 5 of cycles 2 to 9; and melphalan 9 mg/m2 orally daily on days 1, 2, 3, and 4 repeated every 42 days for 9 cycles in combination with daratumumab 16 mg/kg IV every 3 weeks for 8 doses (starting on cycle 2) was evaluated in a randomized, phase III trial (the ALCYONE trial; n = 706). Treatment with daratumumab 16 mg/kg IV every 4 weeks was continued until disease progression or unacceptable toxicity.

However, a meta-analysis by the Prostate Cancer Trialists' Collaborative Group, which included 22 trials with a total of 5710 patients with advanced prostate cancer, found no statistically significant survival advantage with CAB. Medical castration and bilateral orchiectomy were included. The overall mortality rate was % in patients receiving CAB versus % in patients receiving medical or surgical castration alone. Estimated 5-year survival rates were % with CAB and % with castration alone. [ 26 , 27 ] The current American Society of Clinical Oncology (ASCO) guidelines recommend castration alone with either an orchiectomy or GnRH agonist.

Denosumab steroid induced osteoporosis

denosumab steroid induced osteoporosis

However, a meta-analysis by the Prostate Cancer Trialists' Collaborative Group, which included 22 trials with a total of 5710 patients with advanced prostate cancer, found no statistically significant survival advantage with CAB. Medical castration and bilateral orchiectomy were included. The overall mortality rate was % in patients receiving CAB versus % in patients receiving medical or surgical castration alone. Estimated 5-year survival rates were % with CAB and % with castration alone. [ 26 , 27 ] The current American Society of Clinical Oncology (ASCO) guidelines recommend castration alone with either an orchiectomy or GnRH agonist.

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