Cinacalcet in the management of primary hyperparathyroidism: post marketing experience of an Italian multicentre group. (27th April 2013)

• Record Type: Journal Article
• Authors: Saponaro, Federica; Faggiano, Antongiulio; Grimaldi, Franco; Borretta, Giorgio; Brandi, Maria Luisa; Minisola, Salvatore; Frasoldati, Andrea; Papini, Enrico; Scillitani, Alfredo; Banti, Chiara; Prete, Michela Del; Vescini, Fabio; Gianotti, Laura; Cavalli, Loredana; Romagnoli, Elisabetta; Colao, Annamaria; Cetani, Filomena; Marcocci, Claudio
• Is Part Of: Clinical endocrinology. Volume 79:Number 1(2013:Jul.)
• Page Start: 20
• Page End: 26
• Publication Date: 2013-04-27
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12108
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12108-abs-0001"> <title>Summary</title> <sec id="cen12108-sec-0001" sec-type="section"> <title>Objective</title> <p>To report the Italian experience on cinacalcet use following its approval by the European Medical Agency (EMA) to control hypercalcaemia in patients with primary hyperparathyroidism (PHPT).</p> </sec> <sec id="cen12108-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective data collection from 100 patients with sporadic (sPHPT) and 35 with familial PHPT (fPHPT) followed in eight Italian centres between October 2008 and March 2011.</p> </sec> <sec id="cen12108-sec-0003" sec-type="section"> <title>Measurements</title> <p>Albumin‐adjusted serum calcium, PTH, 25OHD, daily cinacalcet dose and adverse events were recorded during the follow‐up (1–46 months).</p> </sec> <sec id="cen12108-sec-0004" sec-type="section"> <title>Results</title> <p>Baseline serum calcium was 2·90 ± 0·27 nmol/l in sPHPT and 2·75 ± 0·17 nmol/l in fPHPT patients (<italic>P </italic>= 0·007). The cinacalcet EMA labelling was met in 53% sPHPT and 26% fPHPT patients. High surgical risk (34%), negative preoperative imaging (19%), control of hypercalcaemia before parathyroidectomy (PTx) (24%), and refusal of PTx (19%) accounted for cinacalcet prescription in 96% of sPHPT patients. Conversely, initial treatment (34%), persistent/relapsing PHPT after surgery (31%), and refusal of PTx (14%) were the indications in 79% fPHPT patients. Cinacalcet was started at 30 mg/daily in 64% of sPHPT and 91% of fPHPT and increased until normocalcaemia was reached or side effects occurred. The final daily dose ranged between 15 and 120 mg. The majority of patients (65% of sPHPT and 80% of fPHPT) become normocalcaemic. Treatment was withdrawn in six patients because of side effects.</p> </sec> <sec id="cen12108-sec-0005" sec-type="section"> <title>Conclusions</title> <p>There is a wide heterogeneity in the prescription of cinacalcet in PHPT patients in Italy and the EMA labelling is not always followed, particularly in fPHPT patients. Cinacalcet effectively reduces serum calcium in patients with either sPHPT or fPHPT.</p> </sec> </abstract>