Secondary hyperparathyroidism (SHPT) patients receiving treatment may see further improvement in anemia with the addition of cinacalcet, a new Japanese study suggests.

Researchers observed a 10% increase in the odds of reaching a hemoglobin target of 10 g/dL for every 6 months of cinacalcet use. That translated into a small hemoglobin increase of 0.042 to 0.067 g/dL.

“The association between cinacalcet use and improvement of anemia in the present study suggests that it could be possible to manage SHPT and anemia simultaneously in an integrated manner,” Motoko Tanaka, MD, of Akeboro Clinic, in Japan, and colleagues wrote in Plos One.

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Using data from the prospective MBD-5D (Mineral and Bone Disorder Outcomes Study for Japanese Chronic Kidney Disease Stage 5D Patients), the investigators compared 1337 SHPT patients (either with intact parathyroid hormone [iPTH] levels of 180 pg/mL or above or taking a vitamin D receptor activator) who newly started cinacalcet with 1864 SHPT patients who did not take the drug.

The groups were generally similar, but cinacalcet users were slightly younger and less likely to have diabetes as the cause of their kidney disease. They were also more likely to be taking multiple treatments: More of them had undergone parathyroidectomy and were taking activated vitamin D drugs, phosphate binders, and iron supplements. In their models, the researchers adjusted for many of these factors. Drug dosages were not assessed. Use of erythropoiesis-stimulating agents and iron supplements did not change after cinacalcet initiation, however.

Cinacalcet might improve anemia by lowering iPTH levels, but there are also other possibilities, such as reduction of fibroblast growth factor 23, the investigators explained. Additional research is needed.

In the competing interests section, the study authors disclosed fees from Kyowa Hakko Kirin, which manufactures cinacalcet (Regpara).

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1.    1. Tanaka M, Yoshida K, Fukuma S, Ito K, Matsushita K, Fukagawa M, et al. (2016) Effects of Secondary Hyperparathyroidism Treatment on Improvement in Anemia: Results from the MBD-5D Study. PLoS ONE 11(10): e0164865. doi:10.1371/journal.pone.0164865.