Etelcalcetide Injection Into Parathyroid Glands Safe
In a pilot study, investigators observed no harmful effects from etelcalcetide injection, and 5 of 10 of patients had a greater than 50% decline in PTH levels.
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NEW ORLEANS—The calcimimetic etelcalcetide can be safely injected directly into parathyroid glands for the treatment of secondary hyperparathyroidism (SHPT) treatment, according to findings from a pilot study presented at the Kidney Week 2017 meeting.
Ten SHPT patients on hemodialysis (mean age 67.8) who experienced nausea from long-term use of oral cinacalcet were switched to injectable etelcalcetide after a more than 2-week washout period. Using real-time ultrasonographic guidance, 1 mL (2.5 mg) of etelcalcetide was injected directly into the parathyroid glands per 1.25 mL of gland volume, until it permeated about 80% of the glands. Investigators observed no adverse effects.
Five patients experienced a greater than 50% decline in PTH levels from an average 270.6 pg/mL at baseline for up to 4 weeks, Satoshi Funakoshi, MD, of Nagasaki Kidney Center in Nagasaki, Japan, and colleagues reported. Five patients had no response to direct injection, but subsequently responded to systemic etelcalcetide. These patients may have had hyperactive glands that were not detected by ultrasound, according to the investigators.
“Direct administration was safe and not associated with any hematoma or laryngeal nerve paresis as has been reported for direct ethanol injection,” Dr Funakoshi and the team concluded. “Percutaneous etelcalcetide injection into the parathyroid glands appears to be cost effective, safe, and a superior option for the treatment of SHPT in HD patients.”
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1. Funakoshi S, Uchino T, Saggi SJ, et al. Efficacy of percutaneous etelcalcetide injection into the parathyroid glands on serum parathyroid hormone (PTH) in hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT): A pilot Study. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Abstract FR-PO813.