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Cinacalcet, vitamin D reduced hyperparathyroidism during hemodialysis

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ASN Renal Week 2011

PHILADELPHIA — Combination cinacalcet and low-dose vitamin D reduced symptoms of hyperparathyroidism among patients undergoing their first year of hemodialysis vs. a flexible dose of vitamin D alone, according to data presented in a poster here.

After 6 months, 57% of patients who received cinacalcet (Sensipar, Amgen) and vitamin D achieved parathyroid hormone levels of 300 pg/mL or less vs. 35% of patients who received flexible vitamin D alone (P=.0002), according to the researchers.

Initial treatment for secondary hyperparathyroidism typically includes vitamin D, calcium supplements and phosphate binders. Treatment with cinacalcet typically begins later, or if other treatments fail, the researchers said.

In the trial, 309 patients who had been on dialysis for 3 to 12 months were randomly assigned to either treatment regimen. The total treatment duration was 12 months, with the primary endpoint assessed at 6 months.

Of those patients on cinacalcet, 63% achieved the primary endpoint, which was a 30% reduction in parathyroid hormone at 6 months, whereas 38% of patients in the vitamin D group achieved that endpoint. When measured at 12 months, 52% of patients who received cinacalcet met the endpoint compared with 44% of those in the vitamin D arm.

Although the use of cinacalcet was associated with low serum calcium levels, no patient withdrew from the study due to hypocalcemia, according to the poster.

For more information:

• Urena PA. Abstract #LB-PO3145. Presented at: the American Society of Nephrology Renal Week; Nov. 8-13, 2011; Philadelphia.

Disclosure: The researchers report receiving pharmaceutical company funding, including from Amgen, Abbott, Genzyme and Fresenius.

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