Effective treatment of hyperphosphatemia with denosumab in patients with loss of function of FGF23 and high bone density: case series

OBJECTIVES: mutations and high bone density. METHODS: patients. Denosumab, a RANKL inhibitor that decreases bone resorption, was administered for more than two years. RESULTS: Denosumab result in a marked and sustained reduction in serum phosphate in all three patients. The two symptomatic patients experienced significant relief from bone pain and improved appetite and well-being. Serum calcium decreased in all patients, with asymptomatic hypocalcemia seen in two cases. Bone density decreased in one patient and was unchanged in another. No significant side effects were observed, except for hypocalcemia. CONCLUSIONS: pathway disorders, though further studies are needed to confirm these findings and determine optimal management strategies.