title: [Use of cinacalcet in clinical practice for the treatment of secondary hyperparathyroidism: analysis of the Italian data of the ECHO study].
abstract: Several studies have shown that, compared with standard therapy, cinacalcet reduces parathyroid hormone (PTH) as well as calcium and phosphorus levels in dialysis patients with secondary hyperparathyroidism (SHPT). The ECHO study evaluated cinacalcet use in actual clinical practice. ECHO enrolled 1865 patients treated with cinacalcet at 187 sites in 12 European countries. In Italy 263 patients were enrolled at 20 sites. The primary objective of the study was to evaluate K/DOQI target achievement in SHPT dialysis patients after the introduction of cinacalcet. Patients on cinacalcet treatment between July 2005 and October 2006 were enrolled and data were collected from 6 months prior to starting cinacalcet up to 12 months after. No treatment algorithm was provided to the investigators. Italian patients had suboptimally controlled SHPT at baseline according to K/DOQI targets (median PTH 760 pg/mL, P 5.4 mg/dL, Ca 9.7 mg/dL). After 1 year of cinacalcet treatment a reduction of PTH (-53.4%), Ca (-7.3%), P (-4.6%) and Ca x P (-14.4%) was observed. The proportion of patients that reached the K/DOQI targets after 1 year of cinacalcet treatment was higher compared to baseline for all parameters (PTH 32% vs 5%; Ca 48% vs 35%; P 59% vs 55%, Ca x P 82% vs 64%). The Italian ECHO data show that cinacalcet treatment increases the proportion of patients achieving the K/DOQI targets for PTH, Ca, P and Ca x P, confirming the effectiveness of cinacalcet in clinical practice in Italy. These findings are consistent with the phase III study results on cinacalcet use in dialysis patients in Europe.
authors.affiliation: Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona. f.malberti@ospedale.cremona.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Malberti
authors.forename: Alberto
authors.initials: A
authors.lastname: Albertazzi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Garibotto
authors.forename: Sergio
authors.initials: S
authors.lastname: Papagni
authors.forename: Elvira
authors.initials: E
authors.lastname: Sicurezza
authors.forename: Fabio
authors.initials: F
authors.lastname: Gambini
authors.forename: Carmela
authors.initials: C
authors.lastname: Piccolo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D007558:Italy; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009281:Naphthalenes / Q000627:therapeutic use*; D011446:Prospective Studies; D006435:Renal Dialysis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D009281:Naphthalenes; D000069449:Cinacalcet