Cinacalcet reduces plasma intact parathyroid hormone, serum phosphate and calcium levels in patients with secondary hyperparathyroidism irrespective of its severity

• Type: Article in International Scientific Journal
• Date: 2011

Authors

João Frazão (Author) FMUP; Messa, P (Author) Other; Mellotte, GJ (Author) Other; Geiger, H (Author) Other; Hagen, EC (Author) Other; Quarles, LD (Author) Other; Kerr, PG (Author) Other; Banos, A (Author) Other; Dehmel, B (Author) Other; Urena, P (Author) Other

Journal

Title: Clinical Nephrology

Vol. 76

Pages: 233-243

ISSN: 0301-0430

Publisher: Dustri-Verlag Dr. Karl Feistle

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 19 Citations

Other information

Authenticus ID: P-002-MTE

DOI: 10.5414/cn106965

Abstract (EN): Aims: To evaluate the relationship between the severity of secondary hyperparathyroidism (SHPT) - defined in terms of baseline plasma intact parathyroid hormone (iPTH) level -and the magnitude of response to cinacalcet. Materials and methods: In this post hoc analysis, data were pooled from three randomized, placebo-controlled trials in which dialysis patients with iPTH >= 300 pg/ml were dose-titrated with cinacalcet or placebo in addition to conventional treatment to achieve iPTH <= 250 pg/ml. In 953 patients analyzed (cinacalcet, 545; placebo, 408), baseline iPTH levels were categorized in 100 pg/ml intervals (300 - >= 1,000 pg/ml), and the impact of baseline iPTH on changes in iPTH, phosphate (P), calcium (Ca) and calcium-phosphate product (Ca x P) was evaluated. Results: Cinacalcet reduced iPTH (47% reduction), P (9%), Ca (7%), and Ca x P (15%) across all subgroups. For patients receiving cinacalcet, the mean percentage reduction from baseline in iPTH varied from 35 to 55%, being consistently decreased across the severity subgroups. The mean absolute change in iPTH was more pronounced in patients with higher baseline iPTH levels, particularly in the >= 1,000 pg/ml subgroup vs. the other subgroups. However, as baseline iPTH levels increased, iPTH <= 250 pg/ml was achieved in fewer patients. A trend towards greater absolute change from baseline was observed for P in patients with more severe disease (iPTH >= 800 pg/ml) treated with cinacalcet compared with patients with less severe disease (iPTH 300 - < 800 pg/ml). Conclusions: Cinacalcet lowers plasma iPTH and serum P, Ca and Ca x P levels in dialysis patients with SHPT, regardless of disease severity. Patients with more severe disease experienced greater reductions in PTH and P, but fewer achieved iPTH <= 250 pg/ml by the efficacy assessment phase. Use of cinacalcet when baseline PTH is lower may result in more stable control of SHPT and help to control bone and mineral alterations.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11