Brand name · Denosumab
Xgeva: adverse event reports filed with FDA
22,746 reports list it as a suspect or interacting product, 2011–2026. Class: RANK ligand inhibitor.
- 22,746
- reports as suspect product
- 0.1% of all reports · about 1,476 a year
- 756
- reports, 12 months to June 2026
- 1,044 in the 12 months before
- 79.6%
- marked serious by the reporter
- 51.1% across the class
- 19.8%
- record death among outcomes, as reported
- 4,493 reports · not verified by FDA
22,746 adverse event reports received by FDA list the brand name Xgeva (denosumab) as a suspect or interacting product, from February 2011 to June 2026. A further 13,180 reports list it only as a concomitant medication, and those are not counted in the figures on this page.
In the 12 months to June 2026, 756 reports listed it, down 28% from 1,044 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 1,476 reports a year and 0.1% of the 20,646,523 reports in the database, and 13.5% of the reports for the RANK ligand inhibitor class. How many people take it is not in the data, so a count is not a rate of occurrence.
The MedDRA terms listed most often are osteonecrosis of jaw (17.7%), death (15.3%) and off label use (6.7%). A report can list several reactions, so shares add to more than 100%; 1,535 different terms appear across these reports. Osteonecrosis of jaw is recorded in 17.7% of these reports, about the same share as in the median RANK ligand inhibitor drug (16.9%).
79.6% of the reports are marked serious by the reporter (51.1% across the class); 19.8% record death among the outcomes and 24.3% record hospitalisation, as reported. 36% of the reports came from other health professionals, and the largest patient age group is 45 to 64 (21.7%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."
Reports by month, five years
Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.
By year received
2026 covers reports received through June 2026 only.
Reactions recorded in the reports
share of Xgeva reports recording the termmedian drug in rank ligand inhibitor
- Osteonecrosis of jawdeath of jaw bone tissue17.7%4,036
- Deaththe patient died; cause not stated by this term15.3%3,481
- Off label useused for a purpose or in a way not on the label6.7%1,523
- Hypocalcaemialow blood calcium5.4%1,229
- Fatiguetiredness4.5%1,033
- Hospitalisationadmission to hospital3.2%729
- Nauseafeeling sick2.8%637
- Diarrhoealoose or frequent stools2.5%576
- Painpain, site not specified2.5%575
- Metastases to bone2.4%555
- Terminal state2.4%547
- Bone painbone pain2.2%491
- Arthralgiajoint pain2.1%483
- Product storage errorthe product was stored wrongly2.1%472
- Astheniaweakness or lack of energy2%465
- Dyspnoeashortness of breath2%462
- Tooth disordera dental problem1.9%431
- Disease progressionthe disease advanced1.8%415
- Back painback pain1.8%411
- Pain in extremitypain in an arm or leg1.7%377
- Neutropenialow neutrophils, a type of white blood cell1.6%373
- Vomitingbeing sick1.6%372
- Pain in jaw1.6%365
- Breast cancer metastatic1.6%356
- Decreased appetitereduced appetite1.6%353
- Pneumonialung infection1.5%351
- Headachehead pain1.4%320
- Anaemialow red blood cells1.4%317
- Malaisegeneral feeling of being unwell1.4%317
Top 30 of 1,535 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 3 drugs in the rank ligand inhibitor class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."
Outcomes recorded
Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 168,671 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."
Patients and reporters
Patient age
Patient sex
Who reported
Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 38% of reports give the United States as the country of the event or reporter.
Reason for use recorded
| Indication as recorded (MedDRA) | Reports | Share |
|---|---|---|
| Prophylaxis | 3,730 | 16.4% |
| Metastases to bone | 3,357 | 14.8% |
| Breast cancer metastatic | 1,093 | 4.8% |
| Breast cancer | 959 | 4.2% |
| Prostate cancer | 791 | 3.5% |
| Prostate cancer metastatic | 577 | 2.5% |
The indication field is filled in by the reporter and is often blank; shares are of all 22,746 reports.
Drugs most often listed in the same reports
| Drug (any role in the report) | Reports | Share of Xgeva reports |
|---|---|---|
| Letrozole | 912 | 4% |
| Ibrance | 850 | 3.7% |
| Calcium | 745 | 3.3% |
| Faslodex | 562 | 2.5% |
| Docetaxel | 559 | 2.5% |
| Dexamethasone | 486 | 2.1% |
| Zometa | 486 | 2.1% |
| Fulvestrant | 441 | 1.9% |
| Xtandi | 428 | 1.9% |
| Trastuzumab | 420 | 1.8% |
Other products listed in reports where Xgeva is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.
In context
| Measure | Xgeva | RANK ligand inhibitor | All reports |
|---|---|---|---|
| Reports as suspect product | 22,746 | 168,671 | 20,646,523 |
| Share of that pool | — | 13.5% | 0.1% |
| Reports, latest 12 months | 756 | — | 1,332,454 |
| Marked serious | 79.6% | 51.1% | 57.4% |
| Death recorded among outcomes, per 1,000 reports | 198 | 132 | 91 |
| Hospitalisation recorded, per 1,000 reports | 243 | 123 | 213 |
| Consumer-filed share | 25.6% | 32.6% | 45.8% |
| Top term, share of reports | Osteonecrosis of jaw 17.7% | median 16.9% | 0.1% |
Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."
Other drugs in the rank ligand inhibitor class
| Drug | Name type | Reports | Latest 12 months | Marked serious |
|---|---|---|---|---|
| Prolia | brand | 137,683 | 3,532 | 43.6% |
| Denosumab | generic | 8,242 | 1,244 | 98% |
Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.
Questions about Xgeva reports
How many adverse event reports has FDA received for Xgeva?
22,746 reports list Xgeva as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 756 of them arrived in the latest 12 months. Another 13,180 list it only as a concomitant medication.
What reactions are recorded in Xgeva reports?
osteonecrosis of jaw (17.7%), death (15.3%), off label use (6.7%), hypocalcaemia (5.4%) and fatigue (4.5%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Xgeva was responsible.
How serious are the reports?
79.6% are marked serious by the reporter. Among the outcomes recorded, 19.8% of reports include death and 24.3% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.
Who files these reports?
other health professional (36%), physician (32.1%) and consumer or non-health professional (25.6%). Most reports reach FDA through the manufacturer, which must forward reports it receives.
Are reports for Xgeva rising?
756 reports in the 12 months to June 2026, down 28% from 1,044 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.
Do these reports show that Xgeva was responsible for these reactions?
No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.
Is this a list of the side effects of Xgeva?
No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.
How do I report an adverse event?
Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.
Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Xgeva as a suspect or interacting product; reports listing it only as a concomitant medication (13,180) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.
Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.