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Cinacalcet use patterns and effect on laboratory values and other medications in a large dialysis organization, 2004 through 2006.
Clin J Am Soc Nephrol. 2009 Feb; 4(2):354-60.CJ

Abstract

BACKGROUND AND OBJECTIVES

Cinacalcet was introduced in mid-2004 to treat secondary hyperparathyroidism in dialysis patients. We aimed to characterize adult patients who received cinacalcet prescriptions and to determine (1) dosage titration and effects on laboratory values, active intravenous vitamin D use, and phosphate binder prescriptions and (2) percentage who achieved National Kidney Foundation Kidney Disease Outcomes Quality Initiative targets for serum parathyroid hormone, calcium, and phosphorus and experienced biochemical adverse effects.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

This observational study evaluated 45,487 prevalent patients from a dialysis organization database linked with the Centers for Medicare and Medicaid Services End-Stage Renal Disease database. Patient characteristics, laboratory values (albumin, parathyroid hormone, calcium, phosphorus), intravenous vitamin D, and oral medication (cinacalcet, phosphate binders) prescriptions were evaluated for cinacalcet patients.

RESULTS

By June 2006, almost 32% of patients had received cinacalcet prescriptions. Mean baseline corrected calcium was 9.8 mg/dl and phosphorus was 6.3 mg/dl, and median parathyroid hormone was 577 pg/ml, versus 9.5 mg/dl, 5.3 mg/dl, and 215 pg/ml, respectively, for noncinacalcet patients. Patients with cinacalcet prescriptions for > or =6 mo had corrected calcium reduced by 4.2%, phosphorus by 7.0%, and parathyroid hormone by 29.9% by 12 mo. More cinacalcet patients attained Kidney Disease Outcomes Quality Initiative targets with less hyperparathyroidism, hypercalcemia, and hyperphosphatemia but more hypoparathyroidism and hypocalcemia. Over 12 mo, vitamin D use and use consistency increased, phosphate binder dosages increased, and mean cinacalcet daily dosage reached 55 mg.

CONCLUSIONS

Patients with cinacalcet prescriptions exhibited more severe hyperparathyroidism and hyperphosphatemia than noncinacalcet patients. Positive effects were less dramatic than in Phase III clinical trials, possibly as a result of modest, slow dosage titration.

Authors+Show Affiliations

Chronic Disease Research Group, Minneapolis Medical Research Foundation, 914 South 8th Street, Suite S-406, Minneapolis, MN 55404, USA. wstpeter@cdrg.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19129318

Citation

St Peter, Wendy L., et al. "Cinacalcet Use Patterns and Effect On Laboratory Values and Other Medications in a Large Dialysis Organization, 2004 Through 2006." Clinical Journal of the American Society of Nephrology : CJASN, vol. 4, no. 2, 2009, pp. 354-60.
St Peter WL, Li Q, Liu J, et al. Cinacalcet use patterns and effect on laboratory values and other medications in a large dialysis organization, 2004 through 2006. Clin J Am Soc Nephrol. 2009;4(2):354-60.
St Peter, W. L., Li, Q., Liu, J., Persky, M., Nieman, K., Arko, C., & Block, G. A. (2009). Cinacalcet use patterns and effect on laboratory values and other medications in a large dialysis organization, 2004 through 2006. Clinical Journal of the American Society of Nephrology : CJASN, 4(2), 354-60. https://doi.org/10.2215/CJN.05241008
St Peter WL, et al. Cinacalcet Use Patterns and Effect On Laboratory Values and Other Medications in a Large Dialysis Organization, 2004 Through 2006. Clin J Am Soc Nephrol. 2009;4(2):354-60. PubMed PMID: 19129318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cinacalcet use patterns and effect on laboratory values and other medications in a large dialysis organization, 2004 through 2006. AU - St Peter,Wendy L, AU - Li,Qi, AU - Liu,Jiannong, AU - Persky,Martha, AU - Nieman,Kimberly, AU - Arko,Cheryl, AU - Block,Geoffrey A, Y1 - 2009/01/07/ PY - 2009/1/9/entrez PY - 2009/1/9/pubmed PY - 2009/6/12/medline SP - 354 EP - 60 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 4 IS - 2 N2 - BACKGROUND AND OBJECTIVES: Cinacalcet was introduced in mid-2004 to treat secondary hyperparathyroidism in dialysis patients. We aimed to characterize adult patients who received cinacalcet prescriptions and to determine (1) dosage titration and effects on laboratory values, active intravenous vitamin D use, and phosphate binder prescriptions and (2) percentage who achieved National Kidney Foundation Kidney Disease Outcomes Quality Initiative targets for serum parathyroid hormone, calcium, and phosphorus and experienced biochemical adverse effects. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This observational study evaluated 45,487 prevalent patients from a dialysis organization database linked with the Centers for Medicare and Medicaid Services End-Stage Renal Disease database. Patient characteristics, laboratory values (albumin, parathyroid hormone, calcium, phosphorus), intravenous vitamin D, and oral medication (cinacalcet, phosphate binders) prescriptions were evaluated for cinacalcet patients. RESULTS: By June 2006, almost 32% of patients had received cinacalcet prescriptions. Mean baseline corrected calcium was 9.8 mg/dl and phosphorus was 6.3 mg/dl, and median parathyroid hormone was 577 pg/ml, versus 9.5 mg/dl, 5.3 mg/dl, and 215 pg/ml, respectively, for noncinacalcet patients. Patients with cinacalcet prescriptions for > or =6 mo had corrected calcium reduced by 4.2%, phosphorus by 7.0%, and parathyroid hormone by 29.9% by 12 mo. More cinacalcet patients attained Kidney Disease Outcomes Quality Initiative targets with less hyperparathyroidism, hypercalcemia, and hyperphosphatemia but more hypoparathyroidism and hypocalcemia. Over 12 mo, vitamin D use and use consistency increased, phosphate binder dosages increased, and mean cinacalcet daily dosage reached 55 mg. CONCLUSIONS: Patients with cinacalcet prescriptions exhibited more severe hyperparathyroidism and hyperphosphatemia than noncinacalcet patients. Positive effects were less dramatic than in Phase III clinical trials, possibly as a result of modest, slow dosage titration. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/19129318/Cinacalcet_use_patterns_and_effect_on_laboratory_values_and_other_medications_in_a_large_dialysis_organization_2004_through_2006_ L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=19129318 DB - PRIME DP - Unbound Medicine ER -