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Abstract: TH-PO150

Etelcalcetide and Long-Term Control of Parathyroid Hormone Levels

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Navarrete, Jose E., Emory University School of Medicine, Atlanta, Georgia, United States
  • Hunt, Vanessa L., HSM Medical Services, Atlanta, Georgia, United States
  • Haeberle, Olivia, HSM Medical Services, Atlanta, Georgia, United States
  • Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
  • Masud, Tahsin, Emory University School of Medicine, Atlanta, Georgia, United States
  • Quyyumi, Anees, Emory University School of Medicine, Atlanta, Georgia, United States
Background

Secondary hyperparathyroidism is a common situation in end stage kidney disease patients receiving hemodialysis. Elevated PTH levels have correlated with vascular complications, accelerated vascular calcification and abnormal bone metabolism, and in clinical practice is used as a surrogate of bone health. Etelcalcetide was approved by the FDA in 2017 for control of moderate to severe hyperparathyroidism in hemodialysis patients. Original studies evaluated the efficacy and safety for a period of up to 26 weeks. The long-term efficacy in controlling PTH levels as well as calcium and phosphorus has not been described.

Methods

All hemodialysis patients treated with Etelcalcetide at Emory hemodialysis centers for at least 3 months were identified and their medical records reviewed. Patients were followed while on treatment if Etelcaetide. Basic demographic information and laboratory data were extracted from the medical record. Median values with IQR are presented unless stated otherwise.

Results

Since 2018, 209 hemodialysis patients were treated with Etelcalcetide and 185 of them received the drug for at least 3 months and represent the study cohort described here. 50% were female. Age was 58 (48-68) years, predominantly Black (96%) and the time on renal replacement therapy before initiation of Etelcalcetide was 4.6 (2.5-7.9) years. Figure 1 shows average PTH, calcium and phosphorus levels during treatment with Etelcalcetide. Median (IQR) PTH levels decreased from 1050pg/mL (861-1396) at time zero to 550pg/mL (351-890) at 6 months and the proportion of patients with PTH below 600 pg/mL was 58.4% compared to 0% at the beginning of treatment. Use of Etelcalcetide was associated with significant reductions of serum calcium specially during the first 6 months of treatment. Phosphorus levels were not significantly affected by the use of Etelcalcetide.

Conclusion

Etelcalcetide was effective lowering serum PTH in a sample of predominantly black patients. The effects of the drug were sustained over a period of 3 years. Treatment with Etelcalcetide was associated with significant decrease in serum calcium during the first 6 months of treatment.