An assessment of cinacalcet HCl effects on bone histology in dialysis patients with secondary hyperparathyroidism

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Malluche, HH (Author) Other; Monier Faugere, MC (Author) Other; Wang, G (Author) Other; João Frazão (Author) FMUP; Charytan, C (Author) Other; Coburn, JW (Author) Other; Coyne, DW (Author) Other; Kaplan, MR (Author) Other; Baker, N (Author) Other; McCary, LC (Author) Other; Turner, SA (Author) Other; Goodman, WG (Author) Other

Journal

Title: Clinical Nephrology

Vol. 69

Pages: 269-278

ISSN: 0301-0430

Publisher: Dustri-Verlag Dr. Karl Feistle

Indexing

ISI Web of Knowledge - 97 Citations

Scopus - 102 Citations

Other information

Authenticus ID: P-004-0B1

Abstract (EN): Aims: Cinacalcet lowers plasma parathyroid hormone (PTH) levels in patients with secondary hyperparathyroidism (sHPT), but the bone histologic response has not been described. This prospective, double-blind, placebo-controlled trial assessed the effects of cinacalcet on bone histology and serum markers of bone metabolism in dialysis patients with sHPT. Methods: Patients with intact PTH (iPTH) >= 300 pg/ml were randomly assigned 2:1 to receive cinacalcet or placebo with concurrent vitamin D and/or phosphate bindertherapy. Cinacalcet (30-180 mg/day) was used to achieve iPTH levels! 200 pg/ml. Bone biopsies were performed before and after one year of treatment. Results: Baseline and end-of-study data were available from 32 patients (19 cinacalcet, 13 placebo). Baseline bone tunnover was elevated in 27, reduced in 3 and normal in 2 patients. Serum bone-specific alkaline phosphatase (BSAP) and N-telopeptide (NTx) were elevated. Cinacalcet treatment decreased PTH and diminished activation frequency, bone formation rate/bone surface, and fibrosis surface/bone surface. Adynamic bone was observed in three patients receiving cinacalcet; in two of these, PTH levels were persistently low (< 100 pg/ml). The histomorphometric parameter changes in bone corresponded to PTH, BSAP and NTx reductions. Bone mineralization parameters remained normal. Conclusions: Treatment with cinacalcet lowered PTH and reduced bone turnover and tissue fibrosis among most dialysis patients with biochemical evience of sHPT.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10