BACKGROUND: Despite extensive use of standard therapy for secondary hyperparathyroidism (sHPT) in dialysis patients, still most patients do not achieve the recommended treatment targets. In a pan-European observational study (ECHO), the effectiveness of the calcimimetic cinacalcet for the treatment of sHPT was evaluated in real-world clinical practice. A sub-analysis of the entire Austrian study cohort is presented. METHODS: Adult dialysis patients who had initiated cinacalcet therapy were included. Data on biochemical parameters of bone and mineral metabolism (intact parathyroid hormone [iPTH], calcium [Ca] and phosphorus [P]) and concurrent medication were collected 6 months prior to the initiation of cinacalcet, at initiation (baseline) and after up to 12 months of active treatment. RESULTS: A total of 320 patients (mean age (±SD): 56 (±14) years) from 34 Austrian dialysis centres were enrolled. At baseline, patients presented with elevated serum iPTH (median 605 pg/ml) and hyperphosphataemia (median 2.1 mmol/l). After 12 months of cinacalcet treatment, serum iPTH (median percentage change -48%), calcium (-2%) and phosphorus (-6%) decreased. The greatest iPTH reduction (-66%) was found in patients with most severe sHPT (>800 pg/ml at baseline). The proportion of patients achieving the recommended NKF/K-DOQI(™) treatment targets increased from baseline to month 12 for iPTH (3-36%) and phosphorus (24 to 39%) and remained stable for calcium (51 to 50%), respectively. No patient had all 3 parameters simultaneously within NKF/K-DOQI(™) treatment targets at baseline, while 7% of patients achieved this treatment goal after 12 months. During the study the use of the phosphate binder sevelamer remained fairly stable, while the relative percentage use of calcium-based phosphate binders increased and the usage of aluminium-containing binders decreased; vitamin D analogue use remained stable. CONCLUSION: Additional use of cinacalcet improved biochemical parameters of bone and mineral metabolism and enabled more patients to achieve and maintain the KDOQI(™) treatment targets for serum iPTH, calcium and phosphorus.
BACKGROUND: Despite extensive use of standard therapy for secondary hyperparathyroidism (sHPT) in dialysis patients, still most patients do not achieve the recommended treatment targets. In a pan-European observational study (ECHO), the effectiveness of the calcimimetic cinacalcet for the treatment of sHPT was evaluated in real-world clinical practice. A sub-analysis of the entire Austrian study cohort is presented. METHODS: Adult dialysis patients who had initiated cinacalcet therapy were included. Data on biochemical parameters of bone and mineral metabolism (intact parathyroid hormone [iPTH], calcium [Ca] and phosphorus [P]) and concurrent medication were collected 6 months prior to the initiation of cinacalcet, at initiation (baseline) and after up to 12 months of active treatment. RESULTS: A total of 320 patients (mean age (±SD): 56 (±14) years) from 34 Austrian dialysis centres were enrolled. At baseline, patients presented with elevated serum iPTH (median 605 pg/ml) and hyperphosphataemia (median 2.1 mmol/l). After 12 months of cinacalcet treatment, serum iPTH (median percentage change -48%), calcium (-2%) and phosphorus (-6%) decreased. The greatest iPTH reduction (-66%) was found in patients with most severe sHPT (>800 pg/ml at baseline). The proportion of patients achieving the recommended NKF/K-DOQI(™) treatment targets increased from baseline to month 12 for iPTH (3-36%) and phosphorus (24 to 39%) and remained stable for calcium (51 to 50%), respectively. No patient had all 3 parameters simultaneously within NKF/K-DOQI(™) treatment targets at baseline, while 7% of patients achieved this treatment goal after 12 months. During the study the use of the phosphate binder sevelamer remained fairly stable, while the relative percentage use of calcium-based phosphate binders increased and the usage of aluminium-containing binders decreased; vitamin D analogue use remained stable. CONCLUSION: Additional use of cinacalcet improved biochemical parameters of bone and mineral metabolism and enabled more patients to achieve and maintain the KDOQI(™) treatment targets for serum iPTH, calcium and phosphorus.
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
Authors: M E Rodriguez; Y Almaden; S Cañadillas; A Canalejo; E Siendones; I Lopez; E Aguilera-Tejero; D Martin; M Rodriguez Journal: Am J Physiol Renal Physiol Date: 2007-01-02
Authors: Jill S Lindberg; Sharon M Moe; William G Goodman; Jack W Coburn; Stuart M Sprague; Wei Liu; Peter W Blaisdell; Robert M Brenner; Stewart A Turner; Kevin J Martin Journal: Kidney Int Date: 2003-01 Impact factor: 10.612
Authors: Pablo Ureña; Stefan H Jacobson; Emanuel Zitt; Marc Vervloet; Fabio Malberti; Neil Ashman; Sean Leavey; Marianne Rix; Ingrid Os; Heikki Saha; Miroslav Ryba; Veronika Bencova; Ana Baños; Valter Zani; Denis Fouque Journal: Nephrol Dial Transplant Date: 2009-04-15 Impact factor: 5.992
Authors: Geoffrey A Block; Steven Zeig; Jared Sugihara; Glenn M Chertow; Eric M Chi; Stewart A Turner; David A Bushinsky Journal: Nephrol Dial Transplant Date: 2008-02-29 Impact factor: 5.992
Authors: David M Spiegel; Lesley McPhatter; Ann Allison; Joanne C Drumheller; Robert Lockridge Journal: Clin J Am Soc Nephrol Date: 2012-02-02 Impact factor: 8.237
Authors: Wolfgang Pronai; Alexander R Rosenkranz; Andreas Bock; Renate Klauser-Braun; Christine Jäger; Gunther Pendl; Margit Hemetsberger; Karl Lhotta Journal: Wien Klin Wochenschr Date: 2017-01-13 Impact factor: 1.704