OBJECTIVE: Cinacalcet (cinacalcet HCl; Sensipar/Mimpara) is a calcimimetic that is a treatment for secondary hyperparathyroidism in patients with renal failure. The objective of this study was to assess the effects of renal function and dialysis on the pharmacokinetics and pharmacodynamics of cinacalcet. METHODS: Two open-label, single-dose (75 mg) studies of cinacalcet were performed: study 1 examined 36 subjects who had renal function ranging from normal to requiring haemodialysis, and study 2 examined ten subjects who were receiving continuous ambulatory peritoneal dialysis. Cinacalcet plasma concentrations were determined using a liquid chromatography-mass spectrometry/mass spectrometry assay. Cinacalcet pharmacokinetics were assessed using noncompartmental analyses. RESULTS: Following single-dose administration of cinacalcet, there was no evidence of increasing exposure with increasing degree of renal impairment, and the pharmacokinetic profile was similar for all subjects regardless of whether they were receiving haemodialysis (no difference on dialysis or nondialysis days detected) or peritoneal dialysis. Protein binding of cinacalcet, determined in study 1 only, was similar in all groups and the level of renal function did not affect the pharmacodynamics (as determined by intact parathyroid hormone and calcium levels). No serious adverse events occurred during either study. CONCLUSION: The degree of renal impairment and mode of dialysis do not affect the pharmacokinetics or pharmacodynamics of cinacalcet. Therefore, the dose of cinacalcet does not need to be altered for degree of renal impairment or dialysis modality.
OBJECTIVE:Cinacalcet (cinacalcet HCl; Sensipar/Mimpara) is a calcimimetic that is a treatment for secondary hyperparathyroidism in patients with renal failure. The objective of this study was to assess the effects of renal function and dialysis on the pharmacokinetics and pharmacodynamics of cinacalcet. METHODS: Two open-label, single-dose (75 mg) studies of cinacalcet were performed: study 1 examined 36 subjects who had renal function ranging from normal to requiring haemodialysis, and study 2 examined ten subjects who were receiving continuous ambulatory peritoneal dialysis. Cinacalcet plasma concentrations were determined using a liquid chromatography-mass spectrometry/mass spectrometry assay. Cinacalcet pharmacokinetics were assessed using noncompartmental analyses. RESULTS: Following single-dose administration of cinacalcet, there was no evidence of increasing exposure with increasing degree of renal impairment, and the pharmacokinetic profile was similar for all subjects regardless of whether they were receiving haemodialysis (no difference on dialysis or nondialysis days detected) or peritoneal dialysis. Protein binding of cinacalcet, determined in study 1 only, was similar in all groups and the level of renal function did not affect the pharmacodynamics (as determined by intact parathyroid hormone and calcium levels). No serious adverse events occurred during either study. CONCLUSION: The degree of renal impairment and mode of dialysis do not affect the pharmacokinetics or pharmacodynamics of cinacalcet. Therefore, the dose of cinacalcet does not need to be altered for degree of renal impairment or dialysis modality.
Authors: William G Goodman; Gerald A Hladik; Stewart A Turner; Peter W Blaisdell; David A Goodkin; Wei Liu; Yousri M Barri; Raphael M Cohen; Jack W Coburn Journal: J Am Soc Nephrol Date: 2002-04 Impact factor: 10.121
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Authors: J E Garrett; I V Capuano; L G Hammerland; B C Hung; E M Brown; S C Hebert; E F Nemeth; F Fuller Journal: J Biol Chem Date: 1995-05-26 Impact factor: 5.157
Authors: A M Alem; D J Sherrard; D L Gillen; N S Weiss; S A Beresford; S R Heckbert; C Wong; C Stehman-Breen Journal: Kidney Int Date: 2000-07 Impact factor: 10.612
Authors: Robert Z Harris; Desmond Padhi; Thomas C Marbury; Robert J Noveck; Margaret Salfi; John T Sullivan Journal: Am J Kidney Dis Date: 2004-12 Impact factor: 8.860
Authors: Geoffrey A Block; Kevin J Martin; Angel L M de Francisco; Stewart A Turner; Morrell M Avram; Michael G Suranyi; Gavril Hercz; John Cunningham; Ali K Abu-Alfa; Piergiorgio Messa; Daniel W Coyne; Francesco Locatelli; Raphael M Cohen; Pieter Evenepoel; Sharon M Moe; Albert Fournier; Johann Braun; Laura C McCary; Valter J Zani; Kurt A Olson; Tilman B Drüeke; William G Goodman Journal: N Engl J Med Date: 2004-04-08 Impact factor: 91.245