{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:54:03Z","timestamp":1774976043534,"version":"3.50.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We examined whether denosumab-induced hypocalcaemia is evident in osteoporosis when given loop diuretics that\u00a0promote urinary calcium excretion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Japanese Spontaneous Adverse Drug Event Reports was analyzed to examine signals for denosumab-induced hypocalcaemia co-administered loop diuretics. We retrospectively included osteoporotic patients to detect predictors for denosumab-induced hypocalcaemia (corrected calcium level\u2009&lt;\u20098.5\u00a0mg\/dL) using multivariate logistic regression analysis. We compared differences in corrected calcium levels (\u0394Ca\u2009=\u2009nadir-baseline).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A significant signal for hypocalcaemia was detected (Reporting odds ratio\u2009=\u2009865.8, 95% confidence interval [95% CI]: 596.8 to 1255.9, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Among 164 patients (hypocalcaemia, 12%), loop diuretics have a significant association with hypocalcaemia (odds ratio [OR]\u2009=\u20096.410, 95% CI: 1.005 to 40.90, <jats:italic>p<\/jats:italic>\u2009=\u20090.0494). However, hypocalcaemia was found to be lower in high corrected calcium levels at baseline (OR\u2009=\u20090.032, 95% CI: 0.005 to 0.209, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and calcium and vitamin D supplementation (OR\u2009=\u20090.285, 95% CI: 0.094 to 0.868, <jats:italic>p<\/jats:italic>\u2009=\u20090.0270). In the non-hypocalcaemia, \u0394Ca decreased significantly in the denosumab plus loop diuretics than in the denosumab alone (-0.9 [-1.3 to -0.7] mg\/dL vs. -0.5 [-0.8 to -0.3] mg\/dL, <jats:italic>p<\/jats:italic>\u2009=\u20090.0156). However, \u0394Ca remained comparable in the hypocalcaemia despite loop diuretics co-administration (-1.0 [-1.2 to -0.8] mg\/dL vs. -0.8 [-1.5 to -0.7] mg\/dL, <jats:italic>p<\/jats:italic>\u2009=\u20090.7904).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Loop diuretics may predispose to developing denosumab-induced hypocalcaemia.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40780-024-00380-8","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T13:03:35Z","timestamp":1727442215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Influence of loop diuretics on denosumab-induced hypocalcaemia in osteoporosis: a retrospective observational analysis"],"prefix":"10.1186","volume":"10","author":[{"given":"Toshinori","family":"Hirai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukari","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Ogura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuka","family":"Sakazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichi","family":"Ishitsuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Sudo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6445-4410","authenticated-orcid":false,"given":"Takuya","family":"Iwamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"key":"380_CR1","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.bone.2010.11.020","volume":"48","author":"R Baron","year":"2011","unstructured":"Baron R, Ferrari S, Russell RG. 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