Endocrine Abstracts

Introduction: The recognition that disease presentation, treatment and outcomes may differ betweenmen and women has become established. We have recently reported a-7.4% rate of denosumab-associated hypocalcemia in community-dwelling osteoporotic patients.

Aim: To investigate the role of gender in this complication.

Methods: A retrospective analysis of medical records (2010–2018) from a large HMO. An albumin-adjusted serum calcium concentration ≤8.5 mg/ml was defined as hypocalcemia.

Results: A total of 1871 women and 134 men were included. Men were older (median 81 vs 77 years, P = 0.004), more likely to receive denosumab as first-line treatment (22% vs 6%, P < 0.001), were treated less with calcium supplements (42% vs 53%, P = 0.024) and had a lower median eGFR level compared to women (66.1 vs 79.9 ml/min/1.73m², P < 0.001).Denosumab-associated hypocalcemia developed in 133 women (7.1%) and in 16 men (11.9%) (P = 0.04). The strongest predictors of hypocalcemia in women were pretreatment levels of albumin-adjusted serum calcium (OR 0.08, 95% CI [0.04, 0.14]) and creatinine (OR 2.43, 95% CI [1.45, 4.05]). There were no predictors for hypocalcemia in men, probably due to the small cohort. Gender was not a predictor for hypocalcemia after propensity matching of 126 men versus 126 women.

Conclusion: Contrary to previous reports, male gender per se is not a risk factor for denosumab-associated hypocalcemia. Despite increasing recognition of male osteoporosis, there was a considerable difference in the number of treated men and women. Men who received denosumab were significantly older with lower GFR, therefore are probably more prone to develop hypocalcemia.