Epileptic seizures associated with denosumab.

Area of Science:

• Pharmacology
• Neurology
• Immunology

Background:

• Denosumab is a monoclonal antibody targeting RANKL, inhibiting bone resorption for osteoporosis and bone metastases.
• The RANKL/RANK/NF-κB pathway is implicated in neuroinflammation and cognitive function.
• RANK receptors are present in the central nervous system.

Purpose of the Study:

• To report the first case of epileptic seizures following denosumab administration.
• To raise awareness of potential neurological adverse events associated with denosumab.
• To contribute to medication safety in osteoporosis treatment.

Main Methods:

• Case report of a patient with osteoporosis experiencing seizures post-denosumab.
• Utilized the Naranjo scale to assess causality.
• Reviewed existing literature on denosumab and the RANKL/RANK pathway.

Main Results:

• A patient developed probable epileptic seizures (Naranjo score 7) after subcutaneous denosumab.
• This suggests a potential link between denosumab and neurological adverse events.
• The findings highlight a rare but serious side effect.

Conclusions:

• Denosumab administration may be associated with a risk of epileptic seizures.
• Clinicians should be vigilant for neurological adverse reactions in patients treated with denosumab.
• Further research is needed to understand the neurobiological mechanisms involved.