Effectiveness of cinacalcet in patients with recurrent/persistent secondary hyperparathyroidism following parathyroidectomy: results of the ECHO study

• Published in: Nephrology, dialysis, transplantation Vol. 26; no. 6; pp. 1956 - 1961
• Main Authors: ZITT, Emanuel, RIX, Marianne, URENA TORRES, Pablo, FOUQUE, Denis, JACOBSON, Stefan H, PETAVY, Frank, DEHMEL, Bastian, RYBA, Miroslav
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-06-2011
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Calcium - blood; Cinacalcet Hydrochloride; Cohort Studies; Emergency and intensive care: renal failure. Dialysis management; Female; Follow-Up Studies; Humans; Hyperparathyroidism, Secondary - drug therapy; Hyperparathyroidism, Secondary - etiology; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Naphthalenes - therapeutic use; Parathyroid Hormone - blood; Parathyroidectomy - adverse effects; Phosphorus - blood; Recurrence; Renal Dialysis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of endocrine glands; Survival Rate; Treatment Outcome; Vitamin D - administration & dosage; Endocrinopathy; Kidney disease; Human; Urinary system disease; secondary hyperparathyroidism; Calcimimetic agent; Hemodialysis; Peptide hormone; clinical practice; Antihormone; Parathyroidectomy; observational study; Extrarenal dialysis; cinacalce; Parathyroid hormone; Parathyroid diseases; Renal failure; Cinacalcet; Hyperparathyroidism
• ISSN: 0931-0509; 1460-2385; 1460-2385
• DOI: 10.1093/ndt/gfq641

Progressive secondary hyperparathyroidism (sHPT) is characterized by parathyroid gland hyperplasia which may ultimately require parathyroidectomy (PTX). Although PTX is generally a successful treatment for those patients subjected to surgery, a significant proportion develops recurrent sHPT following PTX. ECHO was a pan-European observational study which evaluated the achievement of KDOQI(TM) treatment targets with cinacalcet use in patients on dialysis. Previously published results showed that cinacalcet plus flexible vitamin D therapy lowered serum PTH, phosphorus and calcium in the clinical practice with similar efficacy as seen in phase III trials.
This subgroup analysis of ECHO describes the real-world cinacalcet treatment effect in patients with recurrent or persistent sHPT after PTX (n = 153) compared to sHPT patients without prior history of PTX (n = 1696).
Both groups of patients had substantially elevated serum PTH with comparable sHPT severity at baseline. After 12 months of cinacalcet treatment, 20.3% (26/128) of patients with prior PTX and 18.2% (253/1388) of patients without prior PTX achieved serum PTH and Ca × P values within the recommended KDOQI(TM) target ranges.
Our data support the successful use of cinacalcet in patients with recurrent/persistent sHPT after PTX.