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Xgeva (denosumab) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for preventing skeletal-related events in adults with multiple myeloma.
These insights are based on 1,344 comments about Xgeva from MyMyelomaTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Xgeva is a type of medicine called a RANK ligand inhibitor. It works by blocking a protein called RANKL, which helps control the cells that break down bone.
In people with multiple myeloma who have serious bone problems, this helps reduce bone breakdown and lower the risk of bone-related complications.
Doctors prescribe Xgeva when people with multiple myeloma need help preventing skeletal-related events. These include broken bones, the need for radiation or surgery to bone, or spinal cord compression.
By targeting this pathway, the medication may help reduce bone damage and related complications associated with disease activity.
Xgeva is given as an injection under the skin by a healthcare provider.
The recommended dose for multiple myeloma is 120 milligrams given every four weeks as an injection under the skin. Calcium and vitamin D may also be given to help treat or prevent low calcium levels.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 1,344 comments about Xgeva from MyMyelomaTeam members.Members who use Xgeva often say it helps to stay in close contact with both your cancer team and your dentist while you’re on treatment. Many also mention watching for jaw or tooth changes, keeping up with calcium monitoring and supplements if prescribed, and asking about side effects or schedule changes if problems come up.
Keep up with regular dental visits and X-rays.
“Please keep up with your dental appointments if you are on any bone strengthening drugs like Xgeva.”
Tell your doctor right away about jaw pain or mouth changes.
“After a few more weeks, I began having injections of Xgeva with four weeks between injections in my triceps. My jaw began hurting again, and my doctor suggested holding off on further use of Xgeva until the pain in my lower jaw was resolved.”
Make sure your dentist knows you are taking Xgeva.
“You are not supposed to have anything but cleanings and fillings done if you are on Xgeva.”
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In clinical studies of Xgeva for the prevention of skeletal-related events in people with multiple myeloma, the most common side effects occurred in about 11 percent to 34 percent of people. These were:
Xgeva can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Amgen, the manufacturer of Xgeva, offers the Amgen SupportPlus Co-Pay Program. Eligible people with commercial or private insurance may pay as little as $0. If you have government insurance or no insurance, the website offers information on other ways to save on your prescription.
The Amgen SupportPlus Co-Pay Program also offers support from Amgen SupportPlus Representatives to help with questions about coverage and enrollment. To learn more, visit the Amgen SupportPlus Co-Pay Program website or call 866-264-2778.
Before starting Xgeva, your doctor will check your calcium level and treat any low calcium if needed.
Tell your doctor if you have any allergies to denosumab or any ingredients in Xgeva.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Do not take Xgeva if you have low calcium levels.
Do not take Xgeva if you have had a serious allergic reaction to Xgeva or other denosumab products.
Xgeva is also FDA approved to treat adults and skeletally mature adolescents with a giant cell tumor of bone that cannot be removed or where surgery may cause serious problems. It is also used to treat high calcium levels caused by cancer when other treatments called bisphosphonates have not worked.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Xgeva, talk with your doctor about the risks and benefits. Xgeva can harm a baby if used during pregnancy.
Your doctor should check if you are pregnant before starting treatment. If you can become pregnant, use effective birth control during treatment and for at least five months after your last dose.
These answers are fact-checked by our editorial staff.
How effective is Xgeva?
In a study of 1,718 people with newly diagnosed multiple myeloma and bone lesions, Xgeva worked about as well as zoledronic acid in delaying serious bone problems (first skeletal-related event). These events included broken bones, radiation to bone, surgery to bone, or spinal cord compression.
The hazard ratio was 0.98, which means the risk of having one of these bone problems was about the same with both treatments. Overall survival was also similar between the two groups. The hazard ratio was 0.90, meaning there was no meaningful difference in survival between the treatments.
How long does Xgeva take to work for multiple myeloma?
In people with newly diagnosed multiple myeloma who received Xgeva 120 milligrams every four weeks, levels of a bone turnover marker called uNTx/Cr went down by about 75 percent by week 5. These lower levels were maintained from weeks 9 to 49 with continued treatment.
Can Xgeva cause jaw problems in people with multiple myeloma?
Yes. A rare but serious condition called osteonecrosis of the jaw has been reported with Xgeva. In the multiple myeloma study, it was confirmed in 4.1 percent of people who received Xgeva.
Signs may include jaw pain, tooth or gum infection, toothache, bone erosion, or slow healing after dental surgery. Your doctor may recommend a dental exam and preventive dental care before starting treatment. Good oral hygiene is also important during treatment.
On MyMyelomaTeam, people share their experiences with multiple myeloma, get advice, and find support from others who understand.
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