title: "Real-World" use of cinacalcet for managing SHPT in different European countries: analysis of data from the ECHO observational study.
abstract: OBJECTIVE
  The pan-European ECHO observational study evaluated cinacalcet in adult dialysis patients with secondary hyperparathyroidism (SHPT) in "real-world" clinical practice. A sub-analysis compared data for 7 European countries/country clusters: Austria, CEE (Czech Republic and Slovakia), France, Italy, Netherlands, Nordics (Denmark, Finland, Norway, and Sweden), and the UK/Ireland.
  
  
  METHODS
  Data on serum intact parathyroid hormone (iPTH), phosphorous, calcium, as well as the usage of cinacalcet, active vitamin D analogues and phosphate binders were compared.
  
  
  RESULTS
  1,865 patients (mean age 58 years) were enrolled: median baseline iPTH levels ranged from 605 pg/ml in Austria to 954 pg/ml in the UK/Ireland. After ~1 year of cinacalcet, median iPTH reductions from baseline ranged from 38% in the UK/Ireland to 58% in the Netherlands. The proportion of patients achieving NKF/K-DOQITM iPTH targets (150 - 300 pg/ml) at Month 12 ranged from 14% in the UK/Ireland to 40% in CEE. In general, use of sevelamer decreased, while use of calcium-based phosphate binders increased, during cinacalcet treatment. Vitamin D changes were more variable.
  
  
  CONCLUSIONS
  The iPTH level at which cinacalcet is initiated in clinical practice differs considerably among different countries: where cinacalcet was started at a lower iPTH level this resulted in better achievement of serum iPTH targets.
authors.affiliation: VU Medisch Centrum, Amsterdam, The Netherlands. M.Vervloet@vumc.nl
authors.forename: M
authors.initials: M
authors.lastname: Vervloet
authors.forename: V
authors.initials: V
authors.lastname: Bencova
authors.forename: F
authors.initials: F
authors.lastname: Malberti
authors.forename: N
authors.initials: N
authors.lastname: Ashman
authors.forename: I
authors.initials: I
authors.lastname: Os
authors.forename: H
authors.initials: H
authors.lastname: Saha
authors.forename: P
authors.initials: P
authors.lastname: Ureña
authors.forename: E
authors.initials: E
authors.lastname: Zitt
authors.forename: M
authors.initials: M
authors.lastname: Rix
authors.forename: M
authors.initials: M
authors.lastname: Ryba
authors.forename: D
authors.initials: D
authors.lastname: Fouque
authors.forename: B
authors.initials: B
authors.lastname: Dehmel
authors.forename: F
authors.initials: F
authors.lastname: Petavy
authors.forename: S H
authors.initials: SH
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069449:Cinacalcet; D005060:Europe; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D009281:Naphthalenes; D010281:Parathyroid Hormone; D000069449:Cinacalcet