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Abstract: FR-PO126

Real-World Use of Calcimimetics in Small and Independent Hemodialysis Facilities

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Xing, Shan, Amgen, Thousand Oaks, California, United States
  • Lin, Tzu-Chieh, Amgen, Thousand Oaks, California, United States
  • Bhatt, Nisha, Amgen, Thousand Oaks, California, United States
  • Desai, Pooja, Amgen, Thousand Oaks, California, United States
  • Martin, Kevin J., Saint Louis University Med Ctr, St. Louis, Missouri, United States
  • Chonchol, Michel, University of Colorado, Aurora, Colorado, United States
  • Gleeson, Michelle, Outcomes Insights, Westlake Village, California, United States
  • Danese, Mark D., Outcomes Insights, Inc., Westlake Village, CA, California, United States
  • Lubeck, Deborah, Outcomes Insight , Westlake Village, California, United States
Background

In 2018, when etelcalcetide [ETE] became commercially available, dialysis organizations became newly responsible for providing calcimimetics to Medicare patients due to a reimbursement change from Part D to Part B. This study describes calcimimetic utilization and control of circulating parathyroid hormone (PTH), calcium (Ca) and phosphorous (P) in adults with a record of calcimimetics during the first 9 months of 2018 in small and independent hemodialysis facilities (SDO/IDOs).

Methods

This is a retrospective study of electronic health records from SDO/IDOs (Visonex) from 10/1/2017 to 12/31/2018. Adults ≥18 years of age were identified as a Cinacalcet (CIN) or ETE user based on their first calcimimetic in 2018. Patients were followed until kidney transplant, death, or end of data collection. Descriptive analyses of patient characteristics and laboratory control at baseline and follow-up were conducted.

Results

In the first 9 months of 2018, 2601 patients received a calcimimetic (CIN (n=1346, mean (SD) age=60.5 (14.0), 43.5% female, 47.1% black) or ETE (n=1255, mean (SD) age=63.4 (14.5), 46.6% female, 38.5% black). Median (IQR) months of follow-up was 5.0 (2-9) for CIN, and 8.0 (4-11) for ETE. Median (IQR) PTH (pg/mL), P (mg/dl) and Ca at baseline were 670 (356-1094), 5.6 (4.7-6.8), and 9.2 (8.7-9.7)) for CIN; and 686 (453-1044), 5.6 (4.7-6.7), and 9.1 (8.7-9.6), respectively for ETE users. Cut-offs for in-range laboratory measures were: PTH=150-600 pg/mL; P=3.5 – 5.5 mg/dL; and Ca=8.4 – 10.2 mg/dL. See figure for proportion of patients in control for PTH by month.

Conclusion

ETE users in SDO/IDOs had improved control during a longer follow-up compared with CIN, with 61% of patients having PTH in control at 9 months.

Funding

  • Commercial Support