Abstract: TH-PO0505
Etelcalcetide for Secondary Hyperparathyroidism in Cinacalcet-Resistant Patients on Hemodialysis: A Real-World Multicenter Study
Session Information
- Dialysis: Novel Therapeutics and Medication Management
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Qatar
- Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Qatar
- Zidan, Amani, Qatar University, Doha, Qatar
- Alomari, Anees Jamil, Hamad Medical Corporation, Doha, Qatar
- Fouda, Tarek Ahmed Elsayed, Hamad Medical Corporation, Doha, Qatar
- Habib, Safeya, Hamad Medical Corporation, Doha, Qatar
- Mathew, Mincy, Hamad Medical Corporation, Doha, Qatar
- Ateya, Heba Mohamed, Hamad Medical Corporation, Doha, Qatar
- Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Qatar
- Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Qatar
Background
Cinacalcet is an oral calcimimetic effective for controlling secondary hyperparathyroidism (sHPT) in chronic kidney disease (CKD). However, its use is often limited by poor adherence due to gastrointestinal (GI) side effects. Trials showed a similar side effect profile between Etelcalcetide, intravenous calcimimetics, and cinacalcet. We performed a real-world study aimed to evaluate the effectiveness of Etelcalcetide in reducing parathyroid hormone (PTH) levels among hemodialysis (HD) patients with inadequate response or intolerance to cinacalcet.
Methods
This prospective observational cohort study was conducted across all ambulatory HD units in the State of Qatar from January 2021 to October 2023. Eligible patients were adults on chronic HD who were receiving cinacalcet for sHPT. All patients with non-adherence or intolerant to cinacalcet were included. PTH target was defined as 2–9 times the upper limit of normal (130–600 pg/mL).
Results
A total of 146 patients (age 51.7 ± 15.7 years) receiving a median cinacalcet dose of 300 mg/week (IQR: 210) were included. Reasons for switching to Etelcalcetide were nonadherence (44.5%), GI side effects (37.7%), and lack of efficacy (17.8%). After switching to Etelcalcetide, 75.3% achieved full response (PTH < 600 pg/mL), 9.6% partial response (PTH < 800 pg/mL), and 15.1% showed no response. Only one patient discontinued Etelcalcetide due to GI side effects. Median PTH levels after conversion decreased by 54.8% (from a baseline of 918.5 pg/mL (IQR: 547) to 412 pg/mL (IQR: 315) (p < 0.001)). The median time to partial response (PTH < 800 pg/mL) was 2.0 months (95% CI: 1.6–2.4), and to full response (PTH < 600 pg/mL) was 3.0 months (95% CI: 2.5–3.5). Logistic regression identified baseline PTH as the only significant predictor of response: for every 100 pg/mL decrease in baseline PTH, the odds of achieving full response increased by 1.15 (95% CI: 1.1–1.3).
Conclusion
Our real-world multicenter study showed that Etelcalcetide was effective and well tolerated in HD patients with sHPT who are resistant or intolerant to cinacalcet. It enabled most patients to achieve guideline-recommended targets in a relatively short timeframe.
Funding
- Government Support – Non-U.S.