Improved Control of Secondary Hyperparathyroidism in Hemodialysis Patients Switching from Oral Cinacalcet to Intravenous Etelcalcetide, Especially in Nonadherent Patients

Autor:	Marta Arias-Guillén, Manel Vera, Vicens Torregrosa, Marc Xipell, Raquel Ojeda, José Jesús Broseta, María Victoria Rubio, Enrique Montagud-Marrahi, Xavier Filella, Néstor Fontseré, Lida Rodas, Francisco Maduell
Rok vydání:	2019
Předmět:	Adult Male medicine.medical_specialty Cinacalcet Calcium-Regulating Hormones and Agents Calcimimetic medicine.medical_treatment 030232 urology & nephrology Urology Administration Oral 030204 cardiovascular system & hematology Asymptomatic Young Adult 03 medical and health sciences 0302 clinical medicine Renal Dialysis Statistical significance Humans Medicine Prospective Studies Adverse effect Aged Aged 80 and over Etelcalcetide business.industry Hematology General Medicine Middle Aged medicine.disease Nephrology Patient Compliance Administration Intravenous Calcium Female Hyperparathyroidism Secondary Secondary hyperparathyroidism Hemodialysis medicine.symptom Peptides business medicine.drug
Zdroj:	Blood Purification. 48:106-114
ISSN:	1421-9735 0253-5068
Popis:	Background: Etelcalcetide is a novel second-generation calcimimetic that, because of its intravenous administration, could improve treatment adherence in secondary hyperparathyroidism (SHPT). The aim of this study was to evaluate the effectiveness of etelcalcetide compared with that of cinacalcet in controlling SHPT in patients under hemodialysis. Methods: A prospective observational study was performed in 29 patients with SHPT under hemodialysis who switched from cinacalcet to etelcalcetide with a follow-up of 6 months. A survey was conducted of adherence to the oral calcimimetic. The primary end-point of the study was to assess whether etelcalcetide was more effective than cinacalcet in controlling SHPT. Results: After the switch of treatment, none of the patients developed clinical intolerance or new adverse effects. Etelcalcetide was more effective than cinacalcet in controlling intact parathyroid hormone (iPTH), with an overall decrease in iPTH levels that was significant from the second month. Average calcium levels remained within the normal range, with a higher percentage of hypocalcemia with etelcalcetide (6.9 vs. 13.8%), which was asymptomatic in all cases. Patients who were nonadherent to cinacalcet (38%) showed a significant reduction in calcium and iPTH during follow-up with etelcalcetide. The adherent group (62%) also showed a trend to lower iPTH levels reaching statistical significance after 5 months of follow-up. The dose conversion factor for the switch from cinacalcet to etelcalcetide was etelcalcetide/session = 0.111*mg cinacalcet/day + 0.96, R2 = 0.57. Conclusions: Etelcalcetide was more effective than cinacalcet in this patient population, especially in the nonadherent subgroup, leading to better SHPT control without adverse effects.
Databáze:	OpenAIRE
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