Hypercalcemia after denosumab discontinuation in patients with osteoporosis: a systematic review and case report

Key Points

• To examine the occurrence of hypercalcemia after discontinuing denosumab in osteoporosis patients and its implications for treatment.
• Conducted a systematic review of existing literature on hypercalcemia post-denosumab withdrawal.
• Analyzed case reports detailing clinical outcomes after denosumab discontinuation.
• Evaluated the recommended sequential antiresorptive therapies following discontinuation.
• Hypercalcemia is rare but can occur after stopping denosumab, often categorized as mild.
• The phenomenon is linked to increased osteoclast activity, referred to as rebound activation.
• Sequential antiresorptive therapy is strongly advised to mitigate hypercalcemia risks.