Rapid decrease of intact parathyroid hormone could be a predictor of better response to cinacalcet in hemodialysis patients.

Cinacalcet is effective for treating refractory secondary hyperparathyroidism (SHPT), but little is known about the response rates and clinical factors influencing the response.
A prospective, single-arm, multi-center study was performed for 24 weeks. Cinacalcet was administered to patients with intact parathyroid hormone (iPTH) level greater than 300 pg/mL. Cinacalcet was started at a dose of 25 mg daily and titrated until 100 mg to achieve a serum iPTH level<300 pg/mL (primary end point). Early response to cinacalcet was defined as a decrease of iPTH more than 50% within one month.
Fifty-seven patients were examined. Based on the magnitude of iPTH decrease, patients were divided into responder (n=47, 82.5%) and non-responder (n=10, 17.5%) groups. Among the responders, 38 achieved the primary end point, whereas 9 patients showed a reduction in serum iPTH of 30% or more, but did not reach the primary end point. Compared to non-responders, responders were significantly older (p=0.026), female (p=0.041), and diabetics (p<0.001). Additionally, early response was observed more frequently in the responders (30/47, 63.8%), of whom the majority (27/30, 90.0%) achieved the primary end point. Multivariate analysis showed that lower baseline iPTH levels [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.93-0.99], the presence of diabetes (OR 46.45, CI 1.92-1125.6) and early response (OR 21.54, CI 2.94-157.7) were significant clinical factors affecting achievement of iPTH target.
Cinacalcet was effective in most hemodialysis patients with refractory SHPT. The presence of an early response was closely associated with the achievement of target levels of iPTH.
AuthorsJwa-Kyung Kim, Young Joo Kwon, Soo Wan Kim, Yeong-Hoon Kim, Cheol Whee Park, Kyu Bok Choi, Seung Duk Hwang, Kyu Hun Choi
JournalYonsei medical journal (Yonsei Med J) Vol. 54 Issue 2 Pg. 453-63 (Mar 1 2013) ISSN: 1976-2437 [Electronic] Korea (South)
PMID23364981 (Publication Type: Journal Article, Multicenter Study)
Chemical References
  • Biomarkers, Pharmacological
  • Naphthalenes
  • Parathyroid Hormone
  • Cinacalcet Hydrochloride
  • Calcium
  • Adult
  • Aged
  • Biomarkers, Pharmacological (blood)
  • Calcium (blood)
  • Cinacalcet Hydrochloride
  • Female
  • Humans
  • Hyperparathyroidism, Secondary (drug therapy)
  • Male
  • Middle Aged
  • Naphthalenes (adverse effects, therapeutic use)
  • Parathyroid Hormone (blood)
  • Renal Dialysis
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: