ECE2013 Poster Presentations Calcium and Vitamin D metabolism (62 abstracts)
Cinacalcet in patients with primary hyperparathyroidism (PHPT): comparison between sporadic and MEN1 PHPT
Michela Del Prete 1 , Vincenzo Marotta 1 , Valeria Ramundo 1 , Francesca Marciello 1 , Anna Chiara Carratù 1 , Chiara De Luca di Roseto 1 , Raffaella Esposito 1 , Antonella Di Sarno 2 , Annamaria Colao 1 & Antongiulio Faggiano 1,
1Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; 2Interventional Unit, Azienda dei Colli Hospital, Naples, Italy; 3Endocrinology, National Cancer Institute, Fondazione G. Pascale, Naples, Italy.
Introduction: PHPT is a common endocrine disease characterized by hypercalcemia and different degree of osteoporosis and nephrolithiasis. PHPT arises in the context of an inherited disease in 5% of cases. Multiple endocrine neoplasia type 1 (MEN1) is the commonest cause of inherited PHPT. The main therapeutic approach for PHPT is surgery, however many patients refuse or have contraindications for surgery while others, in particular those with MEN1 PHPT, have persistent/relapsing disease after surgery. Cinacalcet is a calciomimetic agent which has been demonstrated to be effective in the control of PHPT.
Aim: The aim of this study was to evaluate and compare the effectiveness of cinacalcet in patients with sporadic and MEN1 PHPT.
Patients and methods: Fifty patients have been enrolled: 25 of them had sporadic PHPT (7 M, 18 F, mean age 67 years) and 25 MEN1 PHPT (9 M, 16 F, mean age 41 years). Serum concentrations of PTH, calcium and phosphorus were evaluated before and 6 and 12 months after starting cinacalcet.
Results: Serum calcium and PTH concentrations significantly decreased in both groups (P<0.01). There were not significant differences between sporadic and MEN1 PHPT in the rate of calcium and PTH concentration decrease after 6 and 12 months of therapy. At 12 month follow-up, the dose of cinacalcet required to normalize calcemia in sporadic PHPT was 30 mg a day in 15 patients and 60 mg in 10 other patients, while in MEN1 PHPT the dose of cinacalcet was 30 mg in 8 patients, 60 mg in 11, 90 mg in 6 other patients.
Conclusions: Cinacalcet is equally effective in normalizing hypercalcemia in sporadic and MEN1 PHPT. However, MEN1-related PHPT required a higher dose of cinacalcet than sporadic PHPT to normalize serum calcium. This contrasts with preliminary published reports and might be explained by the fact that in MEN1 PHPT all parathyroid tissue is affected and hyperfunctioning.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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