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A Systematic Review and Meta-analysis of Efficacy and Safety of Calcimimetic Agents in the Treatment of Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease.
Curr Pharm Des. 2022; 28(40):3289-3304.CP

Abstract

BACKGROUND

Some reports have pointed out that calcimimetics agents are effective in the treatment of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients, but there is no detailed description of the advantages and disadvantages of calcimimetics agents of SHPT in CKD patients. We tried to pool the published data to verify the effectiveness of calcimimetics agents and to compare the advantages and disadvantages of cinacalcet compared with control in the treatment of SHPT in CKD patients.

METHODS

We included eligible studies of published papers from January 1st, 2000 to December 31st, 2020 in Medline, Pubmed and Web of science databases, and the data were extracted for this meta-analysis.

RESULTS

Twenty-seven studies were eligible, and all the included studies were randomized controlled trials (RCT) including patients treated with long-term dialysis. The results indicated that calcimimetic agents can reduce the parathyroid hormone (PTH, pg/ml) level (WMD = -178.22, 95% CI: -238.57, -117.86, P < 0.00001), calcium (Ca, mg/dl) level (WMD = -0.71, 95% CI: -0.86, -0.55, P < 0.00001), phosphorus (P, mg/dl) level (WMD = -0.32, 95% CI: -0.55, -0.08, P = 0.008), calcium-phosphorus product level (WMD = -7.73, 95% CI: -9.64, -5.82, P < 0.00001). Calcimimetic agents increased the bone alkaline phosphatase (BSAP, ng/ml) levels and rate of achieving target PTH, and reduced osteocalcin levels and the rate of parathyroidectomy. Calcimimetic agents increased the total adverse events' rate, the rate of hypocalcemia and gastrointestinal side effects (nausea, vomiting, abdominal pain and diarrhea), but there was no significant difference in serious adverse events between the calcimimetic agent group and control group.

CONCLUSION

Calcimimetic agents can reduce the PTH level, Ca level, P level, calcium-phosphorus product level and do not increase serious adverse events.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Liu Y
Department of Nephrology, the Second Affiliated Hospital, Shantou University Medical College, 515041, Shantou, China.
Yang Q
Department of Nephrology, the Second Affiliated Hospital, Shantou University Medical College, 515041, Shantou, China.
Chen G
Department of Nephrology, the Second Affiliated Hospital, Shantou University Medical College, 515041, Shantou, China.
Zhou T
Department of Nephrology, the Second Affiliated Hospital, Shantou University Medical College, 515041, Shantou, China.

MeSH

HumansCalcimimetic AgentsCalciumNaphthalenesHyperparathyroidism, SecondaryParathyroid HormoneRenal Insufficiency, ChronicPhosphorusRandomized Controlled Trials as Topic

Pub Type(s)

Systematic Review
Meta-Analysis

Language

eng

PubMed ID

36305135

Citation

Liu, Yiping, et al. "A Systematic Review and Meta-analysis of Efficacy and Safety of Calcimimetic Agents in the Treatment of Secondary Hyperparathyroidism in Patients With Chronic Kidney Disease." Current Pharmaceutical Design, vol. 28, no. 40, 2022, pp. 3289-3304.
Liu Y, Yang Q, Chen G, et al. A Systematic Review and Meta-analysis of Efficacy and Safety of Calcimimetic Agents in the Treatment of Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease. Curr Pharm Des. 2022;28(40):3289-3304.
Liu, Y., Yang, Q., Chen, G., & Zhou, T. (2022). A Systematic Review and Meta-analysis of Efficacy and Safety of Calcimimetic Agents in the Treatment of Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease. Current Pharmaceutical Design, 28(40), 3289-3304. https://doi.org/10.2174/1381612829666221027110656
Liu Y, et al. A Systematic Review and Meta-analysis of Efficacy and Safety of Calcimimetic Agents in the Treatment of Secondary Hyperparathyroidism in Patients With Chronic Kidney Disease. Curr Pharm Des. 2022;28(40):3289-3304. PubMed PMID: 36305135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Systematic Review and Meta-analysis of Efficacy and Safety of Calcimimetic Agents in the Treatment of Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease. AU - Liu,Yiping, AU - Yang,Qian, AU - Chen,Guangyong, AU - Zhou,Tianbiao, PY - 2022/05/08/received PY - 2022/09/26/accepted PY - 2022/10/29/pubmed PY - 2022/12/7/medline PY - 2022/10/28/entrez KW - Calcimimetics agents KW - chronic kidney disease (CKD) KW - cinacalcet KW - etelcaletide KW - evocalcet KW - meta-analysis KW - mineral and bone disorder (MBD) KW - secondary hyperparathyroidism (SHPT) SP - 3289 EP - 3304 JF - Current pharmaceutical design JO - Curr Pharm Des VL - 28 IS - 40 N2 - BACKGROUND: Some reports have pointed out that calcimimetics agents are effective in the treatment of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients, but there is no detailed description of the advantages and disadvantages of calcimimetics agents of SHPT in CKD patients. We tried to pool the published data to verify the effectiveness of calcimimetics agents and to compare the advantages and disadvantages of cinacalcet compared with control in the treatment of SHPT in CKD patients. METHODS: We included eligible studies of published papers from January 1st, 2000 to December 31st, 2020 in Medline, Pubmed and Web of science databases, and the data were extracted for this meta-analysis. RESULTS: Twenty-seven studies were eligible, and all the included studies were randomized controlled trials (RCT) including patients treated with long-term dialysis. The results indicated that calcimimetic agents can reduce the parathyroid hormone (PTH, pg/ml) level (WMD = -178.22, 95% CI: -238.57, -117.86, P < 0.00001), calcium (Ca, mg/dl) level (WMD = -0.71, 95% CI: -0.86, -0.55, P < 0.00001), phosphorus (P, mg/dl) level (WMD = -0.32, 95% CI: -0.55, -0.08, P = 0.008), calcium-phosphorus product level (WMD = -7.73, 95% CI: -9.64, -5.82, P < 0.00001). Calcimimetic agents increased the bone alkaline phosphatase (BSAP, ng/ml) levels and rate of achieving target PTH, and reduced osteocalcin levels and the rate of parathyroidectomy. Calcimimetic agents increased the total adverse events' rate, the rate of hypocalcemia and gastrointestinal side effects (nausea, vomiting, abdominal pain and diarrhea), but there was no significant difference in serious adverse events between the calcimimetic agent group and control group. CONCLUSION: Calcimimetic agents can reduce the PTH level, Ca level, P level, calcium-phosphorus product level and do not increase serious adverse events. SN - 1873-4286 UR - https://wwww.unboundmedicine.com/medline/citation/36305135/A_Systematic_Review_and_Meta_analysis_of_Efficacy_and_Safety_of_Calcimimetic_Agents_in_the_Treatment_of_Secondary_Hyperparathyroidism_in_Patients_with_Chronic_Kidney_Disease_ DB - PRIME DP - Unbound Medicine ER -