142 Clinical Characteristics of Geriatric Patients on Denosumab and its Safety Outcome in Geriatric Day-Care, Hospital Kuala Lumpur

Abstract

Abstract Introduction Denosumab had shown significant effectiveness in managing osteoporosis, but there are insufficient safety data worldwide. This study aimed to identify the baseline clinical characteristics of geriatric patients receiving Denosumab and the safety outcome among this population. Methodology This is a descriptive and retrospective cohort study with universal sampling that reviewed medical records of all geriatric patients of 60 years and above who are on Denosumab in Geriatric Day-care, HKL from 2014 to 2018. Patients who were discharged from Geriatric follow-up and those with untraceable records were excluded. Results and Discussions A total sample of 26 patients were recruited, with the mean age of 81.8 (±5.19) years old and predominantly are female (n=22). All patients were diagnosed osteoporosis based on clinical and imaging. More than three-quarter (n=23) of the subjects had bone mineral densitometry (BMD), and the mean T score is -3.02 (±0.88). Twenty-three patients had history of falls and two-third of them had fracture, predominantly lumbar fracture (n=9). The mean creatinine clearance is 33.23 (±9.78) ml/min, and the mean corrected serum calcium is normal. Six patients had history of infections mainly involving respiratory tract infection (n=4), another six patients had pre-existing dermatological and concomitant respiratory disorder respectively. Twelve patients with the aforementioned pre-existing conditions developed recurrent infections (n=9) and worsening of cutaneous reactions (n=3) post Denosumab initiation, where six of them requires rehospitalization and another three patients required Denosumab discontinuation. Hypocalcemia was not reported since there is an inadequate routine serum calcium monitoring post Denosumab. Conclusion Immunization, infective and electrolyte screenings are warranted to serve as structured baseline monitoring for safety profile of patients receiving Denosumab. The findings of this study are crucial to assist with the development of local Denosumab protocol to guide practitioners for the betterment of patient’s management.