The Food and Drug Administration (FDA) recently added a boxed warning to the osteoporosis drug denosumab (Prolia) due to the heightened risk of severe hypocalcemia in patients with advanced chronic kidney disease (CKD). The agency’s decision, based on new evidence and a JAMA review, notes that denosumab increases the risk of severe hypocalcemia compared to bisphosphonates, particularly in CKD patients on dialysis. Severe hypocalcemia can manifest with symptoms like confusion, seizures, irregular heart rhythm, fainting, …
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