Effectiveness of cinacalcet in patients with recurrent/persistent secondary hyperparathyroidism following parathyroidectomy: results of the ECHO study.
BACKGROUND
Progressive secondary hyperparathyroidism (sHPT) is characterized by parathyroid gland hyperplasia which may ultimately require parathyroidectomy (PTX). Although PTX is generally a successful treatment for those patients subjected to surgery, a significant proportion develops recurrent sHPT following PTX. ECHO was a pan-European observational study which evaluated the achievement of KDOQI(TM) treatment targets with cinacalcet use in patients on dialysis. Previously published results showed that cinacalcet plus flexible vitamin D therapy lowered serum PTH, phosphorus and calcium in the clinical practice with similar efficacy as seen in phase III trials.


METHODS
This subgroup analysis of ECHO describes the real-world cinacalcet treatment effect in patients with recurrent or persistent sHPT after PTX (n = 153) compared to sHPT patients without prior history of PTX (n = 1696).


RESULTS
Both groups of patients had substantially elevated serum PTH with comparable sHPT severity at baseline. After 12 months of cinacalcet treatment, 20.3% (26/128) of patients with prior PTX and 18.2% (253/1388) of patients without prior PTX achieved serum PTH and Ca × P values within the recommended KDOQI(TM) target ranges.


CONCLUSIONS
Our data support the successful use of cinacalcet in patients with recurrent/persistent sHPT after PTX.
Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria. Emanuel.Zitt@lkhf.at
Emanuel
E
Zitt
Marianne
M
Rix
Pablo
P
Ureña Torres
Denis
D
Fouque
Stefan H
SH
Jacobson
Frank
F
Pétavy
Bastian
B
Dehmel
Miroslav
M
Ryba
D000368:Aged; D002118:Calcium / Q000097:blood; D000069449:Cinacalcet; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000009:adverse effects*; D010758:Phosphorus / Q000097:blood; D012008:Recurrence; D006435:Renal Dialysis; D015996:Survival Rate; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage
D009281:Naphthalenes; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium; D000069449:Cinacalcet