Abstract: FR-PO140
Etelcalcetide for Managing Secondary Hyperparathyroidism in Hemodialysis Patients
Session Information
- Bone and Mineral Metabolism: Phosphorus, FGF23, Vascular Calcification
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Saito, Tomohiro, Showa University School of Medicine, Yokohama, Japan
- Mizobuchi, Masahide, Showa University School of Medicine, Yokohama, Japan
Background
We retrospectively assessed the efficacy of a new calcimimetic, etelcalcetide, in Japanese chronic hemodialysis patients with secondary hyperparathyroidism (SHPT). The aim of this study was to assess the factors related to the therapeutic effects of etelcalcetide.
Methods
The subjects were 43 patients (average age: 60 years; average dialysis period: 90.7 months) with serum intact parathyroid hormone (iPTH) >240 pg/mL. Intravenous injection of etelcalcetide was started at 15 mg/week for 12 weeks and the dose was adjusted to control the serum levels of iPTH, corrected calcium (cCa), and phosphorus (P).
Results
In total, 81.3% of the patients had a reduction of iPTH of ≥50% at 12 weeks, and 32% achieved the target levels for P, cCa and iPTH. In multivariate analysis, female sex and a history of cinacalcet administration were independent inhibitory factors for iPTH reduction. Compared to patients with a history of cinacalcet administration (n=22), those without this history (n=21) had higher rates of reduction of iPTH of ≥50% (63.6% vs. 95.2%, p=0.007) and of achievement of target levels for P, cCa, and iPTH (22.7% vs. 42.9%, p= 0.15). The side effects in all the subjects during the study period were hypocalcemia (44%), nausea (7%), and muscle spasms (2.3%).
Conclusion
Our results suggest that etelcalcetide can improve management of iPTH together with cCa and P levels in Japanese hemodialysis patients with SHPT. Thus, adherence enhancement and better control of SHPT with etelcalcetide might allow improved management of mineral metabolism, compared to cinacalcet. There was a tendency for iPTH levels to decrease more slowly in patients with a history of cinacalcet administration.
Summary of MBD markers at the end of the 12-week observation period in patients with ((+), n=22) and without ((-), n=21) a history of cinacalcet treatment before etelcalcetide administration.