Extract

I read with interest the recent report by Hu et al (1) about the successful treatment of bisphosphonate “resistant” hypercalcemia of malignancy with high-dose denosumab. Although the need for dialysis was an exclusion criterion, among the 33 study participants, 11 presented with an impaired renal function (defined as glomerular filtration rate < 60 mL/min) and responded well. Because individuals with an estimated creatinine clearance below 30 mL/min were included and “refractory” hypocalcemia after high-dose denosumab treatment remains a concern in renal impairment settings (2–6), it would be of great interest to provide detailed information on serum calcium kinetics of those patients. Did they require a closer monitoring of calcium levels despite previous severe hypercalcemia?

Disclosure Summary: The author has nothing to declare.

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