Pharmacodynamic effects of cinacalcet after kidney transplantation: once- versus twice-daily dose.
BACKGROUND
In the setting of kidney transplantation, cinacalcet has been given, mainly, once daily, but also twice daily. The aims of this prospective study were to assess the acute pharmacodynamic effect of cinacalcet administrated once or twice daily to kidney transplant patients with normal renal function and persisting hypercalcaemia due to hyperparathyroidism and to evaluate 1-year efficacy and tolerance of cinacalcet given at a dose of 30 mg b.i.d.


METHODS
Eleven patients, who received a transplant 6 (6-59) months previously, were included in the study. A first kinetic was done after administration of 60 mg of cinacalcet at 8 a.m. After a washout period of 1 week, the second kinetic was performed with cinacalcet given at 30 mg b.i.d within a 12-h period.


RESULTS
During both kinetics, serum calcium (sCa), ionized calcium (sCa(2+)), albumin-corrected Ca and parathyroid hormone (PTH) levels decreased significantly. At 24 h after the second kinetic, sCa(2+) was significantly lower. After 1 year of cinacalcet treatment, given at the dose of 30 mg b.i.d., there was a significant decrease in sCa, sCa(2+), PTH levels and calcium x phosphorus (Ph) product. In contrast, Ph levels increased significantly. There was no significant change in renal function.


CONCLUSIONS
Once- or twice-daily acute administration of cinacalcet to kidney-transplant patients has similar efficacy. One-year administration of cinacalcet, given as two daily doses, is safe and efficient.
Kamar
Nassim
N
Department of Nephrology, Dialysis and Multi-Organ Transplantation, Toulouse University Hospital, Toulouse, France. kamar.n@chu-toulouse.fr
Gennero
Isabelle
I
Spataru
Luciana
L
Esposito
Laure
L
Guitard
Joelle
J
Lavayssière
Laurence
L
Cointault
Olivier
O
Gandia
Peggy
P
Durand
Dominique
D
Rostaing
Lionel
L
D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D000069449:Cinacalcet; D016572:Cyclosporine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D016559:Tacrolimus / Q000097:blood
D009281:Naphthalenes; D010281:Parathyroid Hormone; D010758:Phosphorus; D016572:Cyclosporine; D002118:Calcium; D000069449:Cinacalcet; D016559:Tacrolimus