Clinical Case Challenge

Dear Friend,

This week, I wanted to do something different. Every week, you guys read this newsletter and my experiences of medicine, work and life in general. This week, I wanted to put you guys to a little test with a clinical case. Let me know if you find these helpful, and we can do more of these in the future. (answers are at the bottom).

To access the case, click here. 

Drug of the week

Denosumab

Denosumab is a monoclonal antibody used primarily to treat osteoporosis and prevention of skeletal-related events in patients with bone metastases.

It works by binding to and inhibiting RANKL (receptor activator of nuclear factor kappa-B ligand), a key protein involved in the formation, function, and survival of osteoclasts—cells responsible for bone resorption.

By reducing osteoclast activity, denosumab decreases bone breakdown, increases bone density, and lowers the risk of fractures.

It is administered as a subcutaneous injection every 6 months for osteoporosis or more frequently in oncology settings.

Common side effects include back pain, musculoskeletal pain, hypocalcemia, and increased risk of infections.

Because it suppresses bone remodeling, there is a risk of rare but serious complications such as osteonecrosis of the jaw and atypical femoral fractures, especially with long-term use.

Calcium and vitamin D supplementation are often recommended during treatment to reduce hypocalcemia risk.