Cinacalet Effective for Long-Term Management of Post-Tx Hyperparathyroidism

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LAS VEGAS—Cinacalcet is effective for the long-term management of persistent hyperparathyroidism after renal transplantation, with deleterious impact on kidney function, according to researchers.

Diane Triolo, MD, and colleagues in the Division of Nephrology at the State University of New York at Stony Brook reviewed data on 37 renal transplant recipients with stable allograft function and persistent hyperparathyroidism receiving cinacalcet over 60 months. The patients had a mean age of 51.7 years (range 31-72 years).

At baseline, 15 patients had low levels of 25-hydroxyvitamin D and 15 (41%) had normal levels. The levels were not measured in seven patients (18%). Four patients (3%) had low levels of 1,25-hydroxyvitamin D and 14 (58%) had normal levels. The levels were not measured in 21 patients.

At baseline, patients had a mean intact parathyroid hormone (iPTH) of 230 pg/mL. At the end of the study after 60 months of cinacalcet the patients had a mean iPTH level of 128, a significant difference from baseline. Nine of 37 patients remained on cinacalcet with a mean dosage of 56 mg/day, whereas 13 patiens discontinued treatment and maintained an iPTH level appropriate for their stage of kidney disease, the authors noted in a poster presentation at the National Kidney Foundation's Spring Clinical Meetings.

In addition, serum calcium levels decreased significantly from 10.26 mg/dL at baseline to 9.64 at study end. Serum phosphorus rose significantly from 2.55 mg/dL to 3.12.

“The biochemical abnormalities associated with persistent hyperparathyroidism appears to improve with the use of cinacalcet in the setting of successful renal transplant,” the authors wrote.

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