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Kidney Week

Abstract: TH-PO175

Successful Story of Conversion of Cinacalcet to Etelcalcetide During the COVID-19 Pandemic

Session Information

  • CKD-MBD: Targets and Outcomes
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Fouda, Tarek Ahmed, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ghonimi, Tarek Abdellatif, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Alomari, Anees Jamil, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Aly, Sahar, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Abdelmagid, Asma, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Taha, Mohed Yousif, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
Background

Hamad general Hospital is the main provider of (HD) in Qatar with 932 patients. We established a team from dialysis nurses under direct nephrologist supervision for management of (MBD). We introduced Etelcalcetide in Qatar in May 2021 for HD patients unable to tolerate oral cinacalcet (GIT symptoms) especially during the COVID-19 pandemic where patients had difficulties dispensing medicine and have proper follow up

Methods

Our study followed patients from May 2021 till March 2022.We included HD for >6 months patients with (HPT) despite being on cinacalcet therapy. Patients recruited from all HD centers (4) in Qatar. Data collected through electronic medical records.

Results

50 patients fulfilled inclusion criteria and were included in study period. Median (PTH) on cinacalcet was 946 pg./ml (Mean 1123pg/ml). After conversion to Etelcalcetide, PTH median level had significant improvement to 623 pg./ml (mean 749 pg./ml). Average improvement in PTH level was 46% (36% of patients with 50% improvement and 48% of patients with >50% improvement). The Median dose for Etelcalcetide was 21.5mg /week. (Patients with within our PTH target range (150-500pg/ml) improved from 8% in May 2021 (on cinacalcet) to 38% in March 2022 (on Etelcalcetide) p=0.0003) while patients with PTH above 800 decreased from 50% to 20% for the same period (p=0.001). Reasons for conversion from Cinacalcet to Etelcalcetide were noncompliance due to GIT side effects (with resistant elevation of PTH despite optimal dose (90% of patients) also due to the COVID-19 pandemic and its effect in following medication in the face of shortage of our nurses and physician.

Conclusion

Our project to optimize MBD management in HD patients with uncontrolled HPT not tolerating Cinacalcet by utilizing Etelcalcetide showed significant improvement in PTH outcomes. It was well tolerated with no reported significant side effects. Utilizing MBD team proven to be a wise decision during the peak of the COVID-19 pandemic with physician shortage and service disturbances.