Cinacalcet reduces plasma intact parathyroid hormone, serum phosphate and calcium levels in patients with secondary hyperparathyroidism irrespective of its severity
Identifieur interne : 006C61 ( Main/Exploration ); précédent : 006C60; suivant : 006C62Cinacalcet reduces plasma intact parathyroid hormone, serum phosphate and calcium levels in patients with secondary hyperparathyroidism irrespective of its severity
Auteurs : J. M. Frazao [Portugal] ; P. Messa [Italie] ; G. J. Mellotte [Irlande (pays)] ; H. Geiger [Allemagne] ; E. C. Hagen [Pays-Bas] ; L. D. Quarles [États-Unis] ; P. G. Kerr [Australie] ; A. Banos [Suisse] ; B. Dehmel [Suisse] ; P. Urena [France]Source :
- Clinical nephrology [ 0301-0430 ] ; 2011.
Descripteurs français
- Pascal (Inist)
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- topic : Homme, Recommandation.
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Abstract
Aims: To evaluate the relationship between the severity of secondary hyperparathyroidism (SHPT) - defined in terms of baseline plasma intact parathyroid hormone (iPTH) level - and the magnitude of response to cinacalcet. Materials and methods: In this post hoc analysis, data were pooled from three randomized, placebo-controlled trials in which dialysis patients with iPTH > 300 pg/ml were dose-titrated with cinacalcet or placebo in addition to conventional treatment to achieve iPTH ≤ 250 pg/ml. In 953 patients analyzed (cinacalcet, 545; placebo, 408), baseline iPTH levels were categorized in 100 pg/ml intervals (300 - ≥ 1,000 pg/ml), and the impact of baseline iPTH on changes in iPTH, phosphate (P), calcium (Ca) and calcium-phosphate product (Ca x P) was evaluated. Results: Cinacalcet reduced iPTH (47% reduction), P (9%), Ca (7%), and Ca × P (15%) across all subgroups. For patients receiving cinacalcet, the mean percentage reduction from baseline in iPTH varied from 35 to 55%, being consistently decreased across the severity subgroups. The mean absolute change in iPTH was more pronounced in patients with higher baseline iPTH levels, particularly in the ≥ 1,000 pg/ml subgroup vs. the other subgroups. However, as baseline iPTH levels increased, iPTH ≤ 250 pg/ml was achieved in fewer patients. A trend towards greater absolute change from baseline was observed for P in patients with more severe disease (iPTH ≥ 800 pg/ml) treated with cinacalcet compared with patients with less severe disease (iPTH 300 - < 800 pg/ml). Conclusions: Cinacalcet lowers plasma iPTH and serum P, Ca and Ca × P levels in dialysis patients with SHPT, regardless of disease severity. Patients with more severe disease experienced greater reductions in PTH and P, but fewer achieved iPTH ≤ 250 pg/ml by the efficacy assessment phase. Use of cinacalcet when baseline PTH is lower may result in more stable control of SHPT and help to control bone and mineral alterations.
Affiliations:
- Allemagne, Australie, France, Irlande (pays), Italie, Pays-Bas, Portugal, Suisse, États-Unis
- District de Darmstadt, Hesse (Land)
- Francfort-sur-le-Main
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Messa</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Nephrology Division - CROFF Policlinico di Milano</s1><s3>ITA</s3><sZ>2 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Nephrology Division - CROFF Policlinico di Milano</wicri:noRegion></affiliation></author><author><name sortKey="Mellotte, G J" sort="Mellotte, G J" uniqKey="Mellotte G" first="G. J." last="Mellotte">G. J. Mellotte</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Adelaide and Meath Hospital</s1><s2>Dublin</s2><s3>IRL</s3><sZ>3 aut.</sZ></inist:fA14><country>Irlande (pays)</country><wicri:noRegion>Adelaide and Meath Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Geiger, H" sort="Geiger, H" uniqKey="Geiger H" first="H." last="Geiger">H. Geiger</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Johann-Wolfgang-Goethe-University</s1><s2>Frankfurt</s2><s3>DEU</s3><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Hagen, E C" sort="Hagen, E C" uniqKey="Hagen E" first="E. C." last="Hagen">E. C. Hagen</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Internal Medicine, Meander Medical Centre</s1><s2>Amersfoort</s2><s3>NLD</s3><sZ>5 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Amersfoort</wicri:noRegion></affiliation></author><author><name sortKey="Quarles, L D" sort="Quarles, L D" uniqKey="Quarles L" first="L. D." last="Quarles">L. D. Quarles</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Internal Medicine, Division of Nephrology, University of Tennessee Health Science Center</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Memphis, TN</wicri:noRegion></affiliation></author><author><name sortKey="Kerr, P G" sort="Kerr, P G" uniqKey="Kerr P" first="P. G." last="Kerr">P. G. Kerr</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Monash Medical Centre and Monash University</s1><s2>Clayton, Victoria</s2><s3>AUS</s3><sZ>7 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Monash Medical Centre and Monash University</wicri:noRegion></affiliation></author><author><name sortKey="Banos, A" sort="Banos, A" uniqKey="Banos A" first="A." last="Banos">A. Banos</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Amgen Europe GmBH</s1><s2>Zug</s2><s3>CHE</s3><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Amgen Europe GmBH</wicri:noRegion></affiliation></author><author><name sortKey="Dehmel, B" sort="Dehmel, B" uniqKey="Dehmel B" first="B." last="Dehmel">B. Dehmel</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Amgen Europe GmBH</s1><s2>Zug</s2><s3>CHE</s3><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Amgen Europe GmBH</wicri:noRegion></affiliation></author><author><name sortKey="Urena, P" sort="Urena, P" uniqKey="Urena P" first="P." last="Urena">P. Urena</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Clinique du Landy</s1><s2>Saint Ouen</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Saint Ouen</wicri:noRegion><wicri:noRegion>Clinique du Landy</wicri:noRegion><wicri:noRegion>Clinique du Landy</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0395718</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0395718 INIST</idno><idno type="RBID">Pascal:11-0395718</idno><idno type="wicri:Area/PascalFrancis/Corpus">001978</idno><idno type="wicri:Area/PascalFrancis/Curation">004566</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001C69</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">001C69</idno><idno type="wicri:doubleKey">0301-0430:2011:Frazao J:cinacalcet:reduces:plasma</idno><idno type="wicri:Area/Main/Merge">007120</idno><idno type="wicri:Area/Main/Curation">006C61</idno><idno type="wicri:Area/Main/Exploration">006C61</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Cinacalcet reduces plasma intact parathyroid hormone, serum phosphate and calcium levels in patients with secondary hyperparathyroidism irrespective of its severity</title><author><name sortKey="Frazao, J M" sort="Frazao, J M" uniqKey="Frazao J" first="J. M." last="Frazao">J. M. Frazao</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Nephrology Research and Development Unit and School of Medicine, Porto University</s1><s2>Porto</s2><s3>PRT</s3><sZ>1 aut.</sZ></inist:fA14><country>Portugal</country><wicri:noRegion>Porto</wicri:noRegion></affiliation></author><author><name sortKey="Messa, P" sort="Messa, P" uniqKey="Messa P" first="P." last="Messa">P. Messa</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Nephrology Division - CROFF Policlinico di Milano</s1><s3>ITA</s3><sZ>2 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Nephrology Division - CROFF Policlinico di Milano</wicri:noRegion></affiliation></author><author><name sortKey="Mellotte, G J" sort="Mellotte, G J" uniqKey="Mellotte G" first="G. J." last="Mellotte">G. J. Mellotte</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Adelaide and Meath Hospital</s1><s2>Dublin</s2><s3>IRL</s3><sZ>3 aut.</sZ></inist:fA14><country>Irlande (pays)</country><wicri:noRegion>Adelaide and Meath Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Geiger, H" sort="Geiger, H" uniqKey="Geiger H" first="H." last="Geiger">H. Geiger</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Johann-Wolfgang-Goethe-University</s1><s2>Frankfurt</s2><s3>DEU</s3><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Hagen, E C" sort="Hagen, E C" uniqKey="Hagen E" first="E. C." last="Hagen">E. C. Hagen</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Internal Medicine, Meander Medical Centre</s1><s2>Amersfoort</s2><s3>NLD</s3><sZ>5 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Amersfoort</wicri:noRegion></affiliation></author><author><name sortKey="Quarles, L D" sort="Quarles, L D" uniqKey="Quarles L" first="L. D." last="Quarles">L. D. Quarles</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Internal Medicine, Division of Nephrology, University of Tennessee Health Science Center</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Memphis, TN</wicri:noRegion></affiliation></author><author><name sortKey="Kerr, P G" sort="Kerr, P G" uniqKey="Kerr P" first="P. G." last="Kerr">P. G. Kerr</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Monash Medical Centre and Monash University</s1><s2>Clayton, Victoria</s2><s3>AUS</s3><sZ>7 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Monash Medical Centre and Monash University</wicri:noRegion></affiliation></author><author><name sortKey="Banos, A" sort="Banos, A" uniqKey="Banos A" first="A." last="Banos">A. Banos</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Amgen Europe GmBH</s1><s2>Zug</s2><s3>CHE</s3><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Amgen Europe GmBH</wicri:noRegion></affiliation></author><author><name sortKey="Dehmel, B" sort="Dehmel, B" uniqKey="Dehmel B" first="B." last="Dehmel">B. Dehmel</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Amgen Europe GmBH</s1><s2>Zug</s2><s3>CHE</s3><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Amgen Europe GmBH</wicri:noRegion></affiliation></author><author><name sortKey="Urena, P" sort="Urena, P" uniqKey="Urena P" first="P." last="Urena">P. Urena</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Clinique du Landy</s1><s2>Saint Ouen</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Saint Ouen</wicri:noRegion><wicri:noRegion>Clinique du Landy</wicri:noRegion><wicri:noRegion>Clinique du Landy</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Clinical nephrology</title><title level="j" type="abbreviated">Clin. nephrol.</title><idno type="ISSN">0301-0430</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Clinical nephrology</title><title level="j" type="abbreviated">Clin. nephrol.</title><idno type="ISSN">0301-0430</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Blood plasma</term><term>Calcimimetic agent</term><term>Calcium phosphate</term><term>Chronic kidney disease</term><term>Cinacalcet</term><term>Human</term><term>Hyperparathyroidism</term><term>Nephrology</term><term>Parathyroid hormone</term><term>Recommendation</term><term>Secondary</term><term>Serum</term><term>Urology</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cinacalcet</term><term>Plasma sanguin</term><term>Hormone parathyroïde</term><term>Néphropathie chronique</term><term>Sérum</term><term>Phosphate de calcium</term><term>Homme</term><term>Secondaire</term><term>Hyperparathyroïdie</term><term>Calcimimétique</term><term>Recommandation</term><term>Néphrologie</term><term>Urologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Recommandation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aims: To evaluate the relationship between the severity of secondary hyperparathyroidism (SHPT) - defined in terms of baseline plasma intact parathyroid hormone (iPTH) level - and the magnitude of response to cinacalcet. Materials and methods: In this post hoc analysis, data were pooled from three randomized, placebo-controlled trials in which dialysis patients with iPTH > 300 pg/ml were dose-titrated with cinacalcet or placebo in addition to conventional treatment to achieve iPTH ≤ 250 pg/ml. In 953 patients analyzed (cinacalcet, 545; placebo, 408), baseline iPTH levels were categorized in 100 pg/ml intervals (300 - ≥ 1,000 pg/ml), and the impact of baseline iPTH on changes in iPTH, phosphate (P), calcium (Ca) and calcium-phosphate product (Ca <sub>x</sub> P) was evaluated. Results: Cinacalcet reduced iPTH (47% reduction), P (9%), Ca (7%), and Ca × P (15%) across all subgroups. For patients receiving cinacalcet, the mean percentage reduction from baseline in iPTH varied from 35 to 55%, being consistently decreased across the severity subgroups. The mean absolute change in iPTH was more pronounced in patients with higher baseline iPTH levels, particularly in the ≥ 1,000 pg/ml subgroup vs. the other subgroups. However, as baseline iPTH levels increased, iPTH ≤ 250 pg/ml was achieved in fewer patients. A trend towards greater absolute change from baseline was observed for P in patients with more severe disease (iPTH ≥ 800 pg/ml) treated with cinacalcet compared with patients with less severe disease (iPTH 300 - < 800 pg/ml). Conclusions: Cinacalcet lowers plasma iPTH and serum P, Ca and Ca × P levels in dialysis patients with SHPT, regardless of disease severity. Patients with more severe disease experienced greater reductions in PTH and P, but fewer achieved iPTH ≤ 250 pg/ml by the efficacy assessment phase. Use of cinacalcet when baseline PTH is lower may result in more stable control of SHPT and help to control bone and mineral alterations.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>Irlande (pays)</li><li>Italie</li><li>Pays-Bas</li><li>Portugal</li><li>Suisse</li><li>États-Unis</li></country><region><li>District de Darmstadt</li><li>Hesse (Land)</li></region><settlement><li>Francfort-sur-le-Main</li></settlement></list><tree><country name="Portugal"><noRegion><name sortKey="Frazao, J M" sort="Frazao, J M" uniqKey="Frazao J" first="J. M." last="Frazao">J. M. Frazao</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Messa, P" sort="Messa, P" uniqKey="Messa P" first="P." last="Messa">P. Messa</name></noRegion></country><country name="Irlande (pays)"><noRegion><name sortKey="Mellotte, G J" sort="Mellotte, G J" uniqKey="Mellotte G" first="G. J." last="Mellotte">G. J. Mellotte</name></noRegion></country><country name="Allemagne"><region name="Hesse (Land)"><name sortKey="Geiger, H" sort="Geiger, H" uniqKey="Geiger H" first="H." last="Geiger">H. Geiger</name></region></country><country name="Pays-Bas"><noRegion><name sortKey="Hagen, E C" sort="Hagen, E C" uniqKey="Hagen E" first="E. C." last="Hagen">E. C. Hagen</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Quarles, L D" sort="Quarles, L D" uniqKey="Quarles L" first="L. D." last="Quarles">L. D. Quarles</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Kerr, P G" sort="Kerr, P G" uniqKey="Kerr P" first="P. G." last="Kerr">P. G. Kerr</name></noRegion></country><country name="Suisse"><noRegion><name sortKey="Banos, A" sort="Banos, A" uniqKey="Banos A" first="A." last="Banos">A. Banos</name></noRegion><name sortKey="Dehmel, B" sort="Dehmel, B" uniqKey="Dehmel B" first="B." last="Dehmel">B. Dehmel</name></country><country name="France"><noRegion><name sortKey="Urena, P" sort="Urena, P" uniqKey="Urena P" first="P." last="Urena">P. Urena</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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