title: Influence on quality of life from an early cinacalcet prescription for secondary hyperparathyroidism in dialysis.
abstract: OBJECTIVE
  The goal of this study is to compare patient-reported quality of life (PRQOL) evolution between two groups of end-stage renal disease patients with secondary hyperparathyroidism (SHPT). The first with a cinacalcet prescription within 3 months after a diagnosis of SHPT (early group) and a second group of patients with a later or no cinacalcet prescription (nonearly group).
  
  
  METHODS
  From 2009 to 2012, we conducted a multicenter pharmaco-epidemiologic study in Lorraine region (France) including all consecutive patients on maintenance dialysis for at least 3 months with a diagnosis of SHPT (PTH > 500 pg/ml or first cinacalcet prescription). PRQOL was estimated using the Kidney Disease Quality Of Life-Short Form questionnaire, at baseline and at 6 and 12 months follow-up. Change in PRQOL was compared between the groups and adjusted with a propensity score.
  
  
  RESULTS
  We included 124 patients: 44 in the early group and 80 in the nonearly group. The mental component summary score was lower in the early group, at baseline (43.6 ± 6.6 vs 46.6 ± 7.6; p = 0.030), and at the follow-up assessment (42.6 ± 6.9 vs 45.7 ± 7.9; p = 0.033). We found no difference between the groups in change in PRQOL, for all dimensions, even after adjustment with the propensity score. Mean serum alkaline phosphatase levels were normal in both groups at baseline (80.9 ± 32.5 vs 95.1 ± 39.6; p = 0.41).
  
  
  CONCLUSIONS
  Cinacalcet prescription immediately following diagnosis of SHPT does not seem to be associated with better PRQOL evolution at 1 year. Mean serum alkaline phosphatase levels suggest that physicians should consider waiting for another PTH assay result before starting cinacalcet in case of a PTH rise.
authors.affiliation: Department of Nephrology, Dialysis, and Transplantation, CHU Nancy, F-54 511, Vandoeuvre-les-Nancy, France; CHU Nancy, Pôle S2R, Epidémiologie et Evaluation Cliniques, Nancy, F-54 000, France; INSERM, CIC-EC, CIC 1433, Nancy, F-54 000, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Filipozzi
authors.forename: Carole
authors.initials: C
authors.lastname: Ayav
authors.forename: Marie-Line
authors.initials: ML
authors.lastname: Erpelding
authors.forename: Michèle
authors.initials: M
authors.lastname: Kessler
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.forename: Luc
authors.initials: L
authors.lastname: Frimat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000378:metabolism; D000069449:Cinacalcet; D003956:Dialysis; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000188:drug therapy*; D007676:Kidney Failure, Chronic; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage / Q000627:therapeutic use*; D011788:Quality of Life
chemical_list: D009281:Naphthalenes; D000069449:Cinacalcet
keywords: chronic kidney disease-mineral and bone disorders; end-stage renal disease; pharmacoepidemiology; quality of life