The Use of Denosumab in a Nonagenarian with Primary Hyperparathyroidism.

Denosumab is a monoclonal antibody which is currently licensed in the UK drug market for the prevention of skeletal-related events secondary to malignancy (excluding myeloma). This monoclonal antibody is a 6 monthly subcutaneous injection that works by lowering calcium levels. When used in a 90 year old patient with primary hyperparathyroidism it demonstrated a dramatic reduction in the calcium level which had proven difficult to reduce by bisphosphonates and who was not a candidate for surgical intervention.