Xgeva is a monoclonal antibody that inactivates RANKL, a protein that enhances osteoclast activity and survival. By inhibiting RANKL, Xgeva prevents skeletal-related events in men with bone metastasis from prostate cancer. Under no circumstances should a man who also has multiple myeloma use Xgeva.
There have been studies that compared Xgeva to zolendronic acid (Zometa). They concluded that the men using Xgeva had a longer period of time before they developed a skeletal-related event (bone metastases or fracture) then those men who received zolendronic acid. Despite this, overall survival was not improved.
When receiving Xgeva you should have normal calcium levels when treatment is started and you should receive supplemental calcium and vitamin D as necessary, so make sure that you monitor your levels.
The most common adverse effects experienced by men receiving Xgeva are fatigue, asthenia, nausea, and low phosphate and calcium levels. It is a good idea for men receiving Xgeva to also have their electrolyte levels monitored. You should also be aware of the risk for developing osteonecrosis of the jaw.
Xgeva has not been studied in men on dialysis or with a creatinine clearance of less than 30 mL per minute.
Xgeva is administered subcutaneously in the upper arm, thigh, or abdomen. The recommended dose is 120 mg subcutaneously every 4 weeks. Prior to its use it should be stored in a refrigerator, then warmed to room temperature in the original container for approximately 15 to 30 minutes before administration. Do not allow your doctor to use any other method to warm the drug.
Also, before I sign off, although it is a day late I want to wish all the fathers a happy and more importantly a HEALTHY Father’s Day.
Joel T Nowak, M.A., M.S.W.
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