Effectiveness and safety of cinacalcet for primary hyperparathyroidism: a single center experience
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- Manaka Katsunori
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
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- Sato Junichiro
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
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- Kinoshita Yuka
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
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- Ito Nobuaki
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
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- Fujita Megumi
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
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- Iiri Taroh
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
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- Nangaku Masaomi
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
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- Makita Noriko
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
Abstract
<p>Primary hyperparathyroidism (PHPT) is a common endocrine disease. Although surgical treatment is curative in most cases, there are few alternative therapies for the hypercalcemia caused by PHPT. Cinacalcet is a positive allosteric modulator of the calcium sensing receptor and was conditionally approved in Japan in 2014 to treat PHPT cases. However, there have been few reports on the outcomes. In our present study, we investigated the efficacy and safety of cinacalcet in 61 PHPT patients who were treated with this agent at our hospital between January 2014 and March 2017. The corrected serum Ca and intact PTH levels were significantly reduced by this treatment, whereas the serum phosphorus levels significantly increased. There were no significant differences in the eGFR or urinary Ca to urinary creatinine ratio between baseline and the maintenance phase. In terms of bone mineral density, there were significant increases observed in the 16 cases for whom a baseline value was available, 11 of whom had been treated for osteoporosis. The most common adverse events from cinacalcet treatment were gastrointestinal symptom, such as nausea and appetite loss. Other adverse events included severe dehydration due to hypercalcemia, myalgia, hypocalcemia, and increased urinary calcium excretion. Seven patients were switched to surgical treatment, and the drug was discontinued in 9 other patients, due to adverse effects. Our present study findings demonstrate that cinacalcet is an effective therapeutic option for PHPT from the perspective of hypercalcemia improvement but that adverse gastrointestinal effects of this drug occur at a frequency of about 10%.</p>
Journal
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- Endocrine Journal
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Endocrine Journal 66 (8), 683-689, 2019
The Japan Endocrine Society