Administering the oral calcimimetic cinacalcet thrice weekly instead of once daily in hemodialysis (HD) patients may be effective for treating secondary hyperparathyroidism (SHPT), according to new research presented at the 2020 National Kidney Foundation live-virtual Spring Clinical Meetings.
In a review of patient data from the DaVita database, mean parathyroid hormone level (PTH) dropped from 908 to 676 pg/mL over 6 months in 1339 HD patients who received cinacalcet thrice weekly and from 897 to 605 pg/mL in 6871 patients who received cinacalcet once daily. At 6 months, similar proportions of both groups had achieved PTH levels less than 600 pg/mL: 67.5% vs 67.9%, respectively, Scott Sibbel, PhD, MPH, and colleagues from DaVita reported.
Ninety-two percent of the thrice-weekly group initiated cinacalcet at a dose of 30 mg, with 63% maintaining that dose to month 4. Approximately 6% required a per-treatment dose of 90 mg or more.
“The majority of patients initiated 3x weekly cinacalcet at a dose of 30 mg per treatment, representing a lower cumulative weekly dose than that typically prescribed for those on daily therapy,” the authors pointed out.
With respect to safety, patients in the thrice-weekly arm had higher serum calcium levels and fewer episodes of hypocalcemia than those in the once-daily group. Hospitalization rates were similar (1.68 vs 1.69 admissions per patient-year, respectively), as were mortality rates (11.4 vs 9.5 deaths per 100 patient years).
“These results suggest that 3x weekly dosing of oral cinacalcet may be an effective therapeutic strategy for the management of SHPT in patients on HD,” Dr Sibbel’s team concluded.
Sibbel S, Hunt AE, Benner D, et al. Comparison of 3x weekly vs daily administration of oral cinacalcet for the control of secondary hyperparathyroidism (SHPT) in patients receiving hemodialysis (HD). Data presented at the live-virtual 2020 National Kidney Foundation Spring Clinical Meetings held March 25 to 29. ePoster 215.