"Real-World" use of cinacalcet for managing SHPT in different European countries: analysis of data from the ECHO observational study.
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.
Vervloet
M
M
VU Medisch Centrum, Amsterdam, The Netherlands. M.Vervloet@vumc.nl
Bencova
V
V
Malberti
F
F
Ashman
N
N
Os
I
I
Saha
H
H
Ureña
P
P
Zitt
E
E
Rix
M
M
Ryba
M
M
Fouque
D
D
Dehmel
B
B
Petavy
F
F
Jacobson
S H
SH
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
D009281:Naphthalenes; D010281:Parathyroid Hormone; D000069449:Cinacalcet