Cinacalcet for SHPT May Lower Testosterone

Serum total and free testosterone declined in men on hemodialysis who received a 6-month course of the drug for secondary hyperparathyroidism.
Serum total and free testosterone declined in men on hemodialysis who received a 6-month course of the drug for secondary hyperparathyroidism.

Cinacalcet treatment for secondary hyperparathyroidism (SHPT) in men on chronic hemodialysis (HD) is associated with decreased serum total and free testosterone, according to a small study.

Piotr Kuczera, MD, and colleagues at the Medical University of Silesia in Katowice, Poland, studied the effect of 6 months of treatment with cinacalcet on serum total and free teosterone in 38 male HD patients with SHPT, defined as a serum parathyroid hormone (PTH) level above 300 pg/mL.

Among 33 patients who completed the study, cinacalcet treatment was associated with a significant decrease in mean serum PTH level from 1,143 pg/mL at baseline to 607 pg/mL after 6 months of treatment, the researchers reported in Kidney & Blood Pressure Research (2016;41:1-8). During the same period, serum total testosterone decreased significantly from 4.95 to 4.39 ng/mL and serum free testosterone decreased significantly from 6.95 to 5.60 pg/mL, respectively. These decreases were associated with the magnitude of serum PTH decrease and dose of cinacalcet, according to the investigators.

Cinacalcet treatment, the investigators noted, may lead to an increased prevalence of testosterone insufficiency and perhaps deficiency, which is associated with comorbidities such as insulin resistance, type 2 diabetes, hypertension, and atherosclerosis.

The investigators acknowledged limitations of their study, including the lack of a placebo group and the relatively small sample size.

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