Cinacalcet HCl reduces hypercalcemia in primary hyperparathyroidism across a wide spectrum of disease severity

Munro Peacock, J. P. Bilezikian, M. A. Bolognese, Michael Borofsky, Simona Scumpia, L. R. Sterling, Sunfa Cheng, Dolores Shoback

Research output: Contribution to journalArticle

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Abstract

Context: Primary hyperparathyroidism (PHPT) is characterized by elevated serum calcium (Ca) and increased PTH concentrations. Objective: The objective of the investigation was to establish the efficacy of cinacalcet in reducing serum Ca in patients with PHPT across a wide spectrum of disease severity. Design and Setting: The study was a pooled analysis of data from three multicenter clinical trials of cinacalcet in PHPT. Patients : Patients were grouped into three disease categories for analysis based on the following: 1) history of failed parathyroidectomy (n = 29); 2) meeting one or more criteria for parathyroid-ectomy but without prior surgery (n = 37); and 3) mild asymptomatic PHPT without meeting criteria for either above category (n = 15). Intervention: The intervention in this study was treatment with cinacalcet for up to 4.5 yr. Outcomes: Measurements in the study included serum Ca, PTH, phosphate, and bone-specific alkaline phosphatase, and areal bone mineral density (aBMD). Vital signs, safety biochemical and hematological indices, and adverse events were monitored throughout the study period. Results: The extent of cinacalcet-induced serum Ca reduction, proportion of patients achieving normal serum Ca (≤10.3 mg/dl), reduction in serum PTH, and increase in serum phosphate were similar across all three categories. Except for decreased aBMD at the total femur indicated for parathyroidectomy group at 1 yr, no significant changes in aBMD occurred. The efficacy of cinacalcet was maintained for up to 4.5 yr of follow-up. AEs were mild and similar across the three categories. Conclusions: Cinacalcet is equally effective in the medical management of PHPT patients across a broad spectrum of disease severity, and overall cinacalcet is well tolerated.

Original languageEnglish (US)
Pages (from-to)E9-E18
JournalJournal of Clinical Endocrinology and Metabolism
Volume96
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Primary Hyperparathyroidism
Hypercalcemia
Serum
Calcium
Bone
Bone Density
Minerals
Parathyroidectomy
Phosphates
Vital Signs
Cinacalcet Hydrochloride
Femur
Surgery
Multicenter Studies
Alkaline Phosphatase
Clinical Trials
Safety
Bone and Bones

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Peacock, M., Bilezikian, J. P., Bolognese, M. A., Borofsky, M., Scumpia, S., Sterling, L. R., ... Shoback, D. (2011). Cinacalcet HCl reduces hypercalcemia in primary hyperparathyroidism across a wide spectrum of disease severity. Journal of Clinical Endocrinology and Metabolism, 96(1), E9-E18. https://doi.org/10.1210/jc.2010-1221

Cinacalcet HCl reduces hypercalcemia in primary hyperparathyroidism across a wide spectrum of disease severity. / Peacock, Munro; Bilezikian, J. P.; Bolognese, M. A.; Borofsky, Michael; Scumpia, Simona; Sterling, L. R.; Cheng, Sunfa; Shoback, Dolores.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 96, No. 1, 01.2011, p. E9-E18.

Research output: Contribution to journalArticle

Peacock, M, Bilezikian, JP, Bolognese, MA, Borofsky, M, Scumpia, S, Sterling, LR, Cheng, S & Shoback, D 2011, 'Cinacalcet HCl reduces hypercalcemia in primary hyperparathyroidism across a wide spectrum of disease severity', Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 1, pp. E9-E18. https://doi.org/10.1210/jc.2010-1221
Peacock, Munro ; Bilezikian, J. P. ; Bolognese, M. A. ; Borofsky, Michael ; Scumpia, Simona ; Sterling, L. R. ; Cheng, Sunfa ; Shoback, Dolores. / Cinacalcet HCl reduces hypercalcemia in primary hyperparathyroidism across a wide spectrum of disease severity. In: Journal of Clinical Endocrinology and Metabolism. 2011 ; Vol. 96, No. 1. pp. E9-E18.
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AB - Context: Primary hyperparathyroidism (PHPT) is characterized by elevated serum calcium (Ca) and increased PTH concentrations. Objective: The objective of the investigation was to establish the efficacy of cinacalcet in reducing serum Ca in patients with PHPT across a wide spectrum of disease severity. Design and Setting: The study was a pooled analysis of data from three multicenter clinical trials of cinacalcet in PHPT. Patients : Patients were grouped into three disease categories for analysis based on the following: 1) history of failed parathyroidectomy (n = 29); 2) meeting one or more criteria for parathyroid-ectomy but without prior surgery (n = 37); and 3) mild asymptomatic PHPT without meeting criteria for either above category (n = 15). Intervention: The intervention in this study was treatment with cinacalcet for up to 4.5 yr. Outcomes: Measurements in the study included serum Ca, PTH, phosphate, and bone-specific alkaline phosphatase, and areal bone mineral density (aBMD). Vital signs, safety biochemical and hematological indices, and adverse events were monitored throughout the study period. Results: The extent of cinacalcet-induced serum Ca reduction, proportion of patients achieving normal serum Ca (≤10.3 mg/dl), reduction in serum PTH, and increase in serum phosphate were similar across all three categories. Except for decreased aBMD at the total femur indicated for parathyroidectomy group at 1 yr, no significant changes in aBMD occurred. The efficacy of cinacalcet was maintained for up to 4.5 yr of follow-up. AEs were mild and similar across the three categories. Conclusions: Cinacalcet is equally effective in the medical management of PHPT patients across a broad spectrum of disease severity, and overall cinacalcet is well tolerated.

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