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Cinacalcet for managing secondary hyperparathyroidism in dialysis patients in clinical practice in Belgium: a 16-month observational study (ECHO-B).
Acta Clin Belg. 2013 Jul-Aug; 68(4):275-81.AC

Abstract

In Belgium, the calcimimetic cinacalcet is initially reimbursed for < or = 4 months in dialysis patients with secondary hyperparathyroidism (SHPT) and intact parathyroid hormone (iPTH) > or = 800 pg/mL, or iPTH 300-800 pg/ mL and Ca x P > 55 mg 2/dL2 despite > or = 6 months' optimal treatment with vitamin D sterols and/or phosphate binders. The Belgian, multicentre, observational study ECHO-B evaluated cinacalcet in such patients. Patients who began cinacalcet treatment after March 1, 2007 were eligible. Data were collected retro/prospectively from 6 months before until 16 months after starting cinacalcet (whether or not cinacalcet was continued). Median iPTH was markedly elevated (816 [IQR 551-991] pg/mL) at baseline (the time of starting cinacalcet), but decreased continuously over the course of the study, reaching a value of 414 pg/mL (IQR 240-641; median change -41%) at 4 months, 335 pg/mL (IQR 159-616; -60%) at 12 months and 250 pg/mL (IQR 172-436; -64%) at 16 months. Reductions in serum calcium (-7%) and phosphorus (-13%) were already (near) maximal at 4 months. The primary outcome (iPTH 150-300 pg/mL and/or a > or = 30% reduction within 4 months of starting cinacalcet; criterion for continued reimbursement in Belgium) was achieved in 65/81 patients (80%; 95% CI 72-89%). Results show that in dialysis patients with SHPT in real-life clinical practice, mineral metabolism improves after starting cinacalcet: our study findings suggest that PTH levels may continue decreasing after 12 months' treatment in this setting.

Authors+Show Affiliations

Service de Néphrologie et Dialyse, CH EpiCURA Baudour, Baudour, Belgium. frederic.debelle@epicura.beDienst nefrologie, az Groeninge, Kortrijk, Belgium.Clinique de Néphrologie-Dialyse, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium.H.-Hartziekenhuis Roeselare-Menen, Roeselare, Belgium.Nephrology Section OK12, University Hospital, Gent, Belgium.Informatique médicale et Biostatistique, Université de Liège, Liège, Belgium.Amgen, Brussels, Belgium.Service de Néphrologie, Cliniques Universitaires Saint Luc, Université catholique de Louvain, Bruxelles, Belgium.

Pub Type(s)

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

Language

eng

PubMed ID

24455797

Citation

Debelle, F, et al. "Cinacalcet for Managing Secondary Hyperparathyroidism in Dialysis Patients in Clinical Practice in Belgium: a 16-month Observational Study (ECHO-B)." Acta Clinica Belgica, vol. 68, no. 4, 2013, pp. 275-81.
Debelle F, Meeus G, Dratwa M, et al. Cinacalcet for managing secondary hyperparathyroidism in dialysis patients in clinical practice in Belgium: a 16-month observational study (ECHO-B). Acta Clin Belg. 2013;68(4):275-81.
Debelle, F., Meeus, G., Dratwa, M., Maes, B., Vanholder, R., Albert, A., Schutyser, E., & Jadoul, M. (2013). Cinacalcet for managing secondary hyperparathyroidism in dialysis patients in clinical practice in Belgium: a 16-month observational study (ECHO-B). Acta Clinica Belgica, 68(4), 275-81.
Debelle F, et al. Cinacalcet for Managing Secondary Hyperparathyroidism in Dialysis Patients in Clinical Practice in Belgium: a 16-month Observational Study (ECHO-B). Acta Clin Belg. 2013;68(4):275-81. PubMed PMID: 24455797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cinacalcet for managing secondary hyperparathyroidism in dialysis patients in clinical practice in Belgium: a 16-month observational study (ECHO-B). AU - Debelle,F, AU - Meeus,G, AU - Dratwa,M, AU - Maes,B, AU - Vanholder,R, AU - Albert,A, AU - Schutyser,E, AU - Jadoul,M, PY - 2014/1/25/entrez PY - 2014/1/25/pubmed PY - 2014/3/13/medline SP - 275 EP - 81 JF - Acta clinica Belgica JO - Acta Clin Belg VL - 68 IS - 4 N2 - In Belgium, the calcimimetic cinacalcet is initially reimbursed for < or = 4 months in dialysis patients with secondary hyperparathyroidism (SHPT) and intact parathyroid hormone (iPTH) > or = 800 pg/mL, or iPTH 300-800 pg/ mL and Ca x P > 55 mg 2/dL2 despite > or = 6 months' optimal treatment with vitamin D sterols and/or phosphate binders. The Belgian, multicentre, observational study ECHO-B evaluated cinacalcet in such patients. Patients who began cinacalcet treatment after March 1, 2007 were eligible. Data were collected retro/prospectively from 6 months before until 16 months after starting cinacalcet (whether or not cinacalcet was continued). Median iPTH was markedly elevated (816 [IQR 551-991] pg/mL) at baseline (the time of starting cinacalcet), but decreased continuously over the course of the study, reaching a value of 414 pg/mL (IQR 240-641; median change -41%) at 4 months, 335 pg/mL (IQR 159-616; -60%) at 12 months and 250 pg/mL (IQR 172-436; -64%) at 16 months. Reductions in serum calcium (-7%) and phosphorus (-13%) were already (near) maximal at 4 months. The primary outcome (iPTH 150-300 pg/mL and/or a > or = 30% reduction within 4 months of starting cinacalcet; criterion for continued reimbursement in Belgium) was achieved in 65/81 patients (80%; 95% CI 72-89%). Results show that in dialysis patients with SHPT in real-life clinical practice, mineral metabolism improves after starting cinacalcet: our study findings suggest that PTH levels may continue decreasing after 12 months' treatment in this setting. SN - 1784-3286 UR - https://wwww.unboundmedicine.com/medline/citation/24455797/Cinacalcet_for_managing_secondary_hyperparathyroidism_in_dialysis_patients_in_clinical_practice_in_Belgium:_a_16_month_observational_study__ECHO_B__ DB - PRIME DP - Unbound Medicine ER -