{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:35:37Z","timestamp":1792467337301,"version":"4.5.0"},"reference-count":26,"publisher":"The Endocrine Society","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The 2023 Endocrine Society guideline conditionally favors denosumab over intravenous (IV) bisphosphonates for hypercalcemia of malignancy (HCM), but direct comparative evidence is scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare effectiveness of denosumab vs bisphosphonates for the treatment of HCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Setting<\/jats:title>\n                    <jats:p>Observational cohort study of adults hospitalized with HCM between January 2016 and January 2026 at a large academic safety-net hospital system in the Bronx, NY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Adults aged \u226518 years with serum calcium &amp;gt;10.5\u2005mg\/dL, active or prior malignancy, and treated with denosumab or bisphosphonates as inpatient. Patients with estimated glomerular filtration rate &amp;lt;15\u2005mL\/minute\/1.73\u2005m2 or recent antiresorptive exposure were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Denosumab vs IV bisphosphonate (zoledronic acid or pamidronate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Primary outcome was time to serum calcium normalization (\u226410.5\u2005mg\/dL). Secondary outcomes included hypocalcemia, hypercalcemia recurrence, and 90-day all-cause mortality. Propensity score overlap weighting balanced baseline covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 836 patients (mean age 67.0 years; 50.1% female; 44.9% non-Hispanic Black, 29.9% Hispanic) contributing 869 admissions, 814 (93.7%) received bisphosphonates and 55 (6.3%) denosumab. Time to normalization was similar (median 1.62 vs 1.58 days; HR 0.80; 95% CI, 0.57-1.12 for denosumab vs bisphosphonates). Hypocalcemia (HR 0.86; 95% CI, 0.58-1.26) and 90-day recurrence (HR 0.97; 95% CI, 0.54-1.74) did not differ between denosumab vs bisphosphonates. Ninety-day mortality was lower with denosumab (HR 0.51; 95% CI, 0.30-0.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Denosumab and bisphosphonates were associated with similar calcium normalization, hypocalcemia, and recurrence rates in this real-world observational cohort. The lower 90-day mortality observed with denosumab warrants prospective investigation given the limitations of observational research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag417","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:45:57Z","timestamp":1791459957000},"source":"Crossref","is-referenced-by-count":1,"title":["Comparative effectiveness of denosumab versus bisphosphonates for hypercalcemia of malignancy: a real-world cohort study"],"prefix":"10.1210","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7064-1873","authenticated-orcid":false,"given":"Jovan","family":"Milosavljevic","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice Y","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendon","family":"Fusco","sequence":"additional","affiliation":[{"name":"Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Videlefsky","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine , Bronx, NY 10461 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasim","family":"Gucalp","sequence":"additional","affiliation":[{"name":"Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vafa","family":"Tabatabaie","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"issue":"3","key":"2026101911321071900_dgag417-B1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1210\/clinem\/dgac621","article-title":"Treatment of hypercalcemia of malignancy in adults: an endocrine society clinical practice guideline","volume":"108","author":"El-Hajj Fuleihan","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2026101911321071900_dgag417-B2","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1002\/cam4.749","article-title":"Prevalence of hypercalcemia among cancer patients in the United States","volume":"5","author":"Gastanaga","year":"2016","journal-title":"Cancer Med"},{"issue":"5","key":"2026101911321071900_dgag417-B3","first-page":"496","article-title":"Hypercalcemia of malignancy","volume":"9","author":"Feldenzer","year":"2018","journal-title":"J Adv Pract Oncol"},{"issue":"7","key":"2026101911321071900_dgag417-B4","doi-asserted-by":"crossref","first-page":"499","DOI":"10.7326\/0003-4819-112-7-499","article-title":"Cancer-associated hypercalcemia: morbidity and mortality. 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