Bone metabolism after cinacalcet administration in patients with secondary hyperparathyroidism.

Abstract

Cinacalcet, an allosteric modulator of a calcium (Ca)-sensing receptor, significantly suppresses parathyroid hormone (PTH) secretion and bone turnover rate in chronic hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT). In this study, bone metabolism after cinacalcet treatment was examined, because hungry bone syndrome is sometimes experienced after parathyroidectomy in severe SHPT. We conducted a prospective observational study in 17 HD patients with SHPT. Cinacalcet was started at 25 mg/day, and the dose was increased step by step based on serum calcium level. A significant decrease in serum Ca and intact PTH concentration was found within 2 weeks. Tartrate-resistant acid phosphatase 5b, a good bone resorption marker, was significantly decreased at week 2 of the study. Serum bone alkaline phosphatase, a marker of bone formation, was increased at week 2 compared with the basal level. It became, however, gradually decreased until week 14. Only one patient whose bone turnover was considerably high had a mild numbness feeling. These results suggest that cinacalcet treatment might transiently accelerate bone formation with rapid suppression of bone resorption. This uncoupling could be involved in a mechanism by which cinacalcet decreases serum Ca level.

• Authors: Shozo Yano, Keiko Suzuki, Masaaki Sumi, Akihide Tokumoto, Kazushi Shigeno, Yasutoshi Himeno, Toshitsugu Sugimoto
• Journal: Journal of bone and mineral metabolism (J Bone Miner Metab) Vol. 28 Issue 1 Pg. 49-54 ( 2010) ISSN: 1435-5604 [Electronic] Japan
• PMID: 19548062 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Hormone Antagonists
• Isoenzymes
• Naphthalenes
• Parathyroid Hormone
• Phosphorus
• Alkaline Phosphatase
• Acid Phosphatase
• Tartrate-Resistant Acid Phosphatase
• Calcium
• Cinacalcet

Topics

• Acid Phosphatase (blood)
• Alkaline Phosphatase (blood)
• Biomarkers (blood)
• Bone Regeneration (drug effects)
• Bone Remodeling (drug effects)
• Bone Resorption (prevention & control)
• Bone and Bones (drug effects, metabolism)
• Calcium (blood)
• Cinacalcet
• Drug Administration Schedule
• Female
• Hormone Antagonists (administration & dosage, adverse effects, pharmacology)
• Humans
• Hyperparathyroidism, Secondary (blood, metabolism, therapy)
• Isoenzymes (blood)
• Male
• Middle Aged
• Naphthalenes (administration & dosage, adverse effects, pharmacology)
• Parathyroid Hormone (antagonists & inhibitors, blood)
• Phosphorus (blood)
• Renal Dialysis
• Tartrate-Resistant Acid Phosphatase
• Time Factors