Endocrine Abstracts

Denosumab is a fully human MAB that inhibits bone resorption by neutralizing RANKL and was licensed in 2010 for the treatment of post-menopausal osteoporosis. It was first integrated in a northwest trust, under the care of the metabolic and bone disease department, as a second line treatment.

Since 2012 denosumab has been used in the outpatient clinic under a shared care agreement with the greater Manchester medicines management group, this agreement ensured patients were catered for the first 12 months in the hospital environment and then followed up in the community.

The administration of denosumab 60 mg/1 ml is a 6 monthly s.c. injection uses a prefilled syringe, it is stored in a refrigerator and once removed can be stored at room temperature for 28 days.

The experience of integrating a new drug into practice has implications for clinic capacity, and the patients. The patients have found it to be a positive experience as they can contact the helpline number to arrange a mutually convenient time to attend. This in turn reduces the waiting time in clinic. It also allows patients that were previously unsuitable for some osteoporosis treatments due to allergies or a reduced renal function to have the drug. The drug can be given quickly and as anaphylaxis is not a side effect of the drug patients do not have to wait after the injection and there is no fasting regimes patients only have to attend clinic twice for the injection and can have the rest of their treatments at their local general practice.

The benefit for practice is autonomy for the nurse, the patient experience is enhanced and a therapeutic relationship is formed built upon trust using the best available evidence, and concordance and compliance is increased due to decreased side effects.