Denosumab is injected subcutaneously every 6 months.
When to consider denosumab:
(1) The patient has severe osteoporosis.
(2) The patient has failed to respond to bisphosphonates.
(3) The patient cannot take bisphosphonate therapy due to adverse effects (intolerant) or contraindications.
Comorbid conditions that may make denosumab therapy attractive for the patient:
(1) renal failure: The dose does not need to be adjusted for renal failure.
(2) gastrointestinal disease: It can be used in a patient with malabsorption that interferes with oral drug therapy.
Reasons to avoid denosumab:
(1) hypocalcemia
(2) allergic reaction to denosumab (including serum sickness)
(3) other serious adverse side effects with denosumab
(4) failure to respond to denosumab
