For patients with poor tolerance or compliance to oral cinacalcet therapy or no response, converting to intravenous etelcalcetide can improve parathyroid hormone (PTH) levels, according to new study findings presented at the 2022 American Dialysis Conference.
In a study of 36 patients with secondary hyperparathyroidism receiving hemodialysis, 90% were intolerant or nonadherent to optimally dosed cinacalcet due to gastrointestinal or other side effects or lack of response. Median PTH at baseline was 1176 pg/mL.
After conversion to etelcalcetide, median PTH significantly declined to 699 pg/mL over 6 months, Abdullah Hamad, MD, of Hamad Medical Corporation in Qatar and colleagues reported. A greater than 30% improvement in PTH occurred in 58% of patients; 30% of patients had a greater than 65% improvement. No improvement occurred in 11%.
Target range PTH (150-500 pg/mL) significantly increased from 8% to 30% of patients. The proportion of patients with PTH levels exceeding 800 pg/mL significantly decreased from 50% to 28%. The median dose of etelcalcetide was 21.5 mg/wk.
“Our project to convert cinacalcet to etelcalcetide in hemodialysis patients with secondary hyperparathyroidism showed significant improvement in PTH level,” Dr Hamad’s team concluded in a poster presentation. “It was well-tolerated with no reported side effects.”
The investigators noted that uncontrolled secondary hyperparathyroidism can lead to bone pain and contribute to fractures risk.
Hamad A, Fouda T, Jamil A, et al. Conversion of cinacalcet to etelcalcetide for uncontrolled hyperparathyroidism in hemodialysis patients. Presented at the American Dialysis Conference, March 4-6, 2022.