Experience in the treatment of primary hyperparathyroidism with cinacalcet: data after 12 months of treatment

Ines Luque-Fernandez; Antonia Garcia-Martin; Alessandra Luque-Pazos; Julia Sastre-Marcos; Almudena Vicente-Delgado; Amparo Marco-Martinez; Barbara Canovas

doi:10.1530/endoabs.32.P145

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Endocrine Abstracts (2013) 32 P145 | DOI: 10.1530/endoabs.32.P145

ECE2013 Poster Presentations Calcium and Vitamin D metabolism (62 abstracts)

Experience in the treatment of primary hyperparathyroidism with cinacalcet: data after 12 months of treatment

Inés Luque-Fernández ¹ , Antonia García-Martín ² , Alessandra Luque-Pazos ¹ , Julia Sastre-Marcos ¹ , Almudena Vicente-Delgado ¹ , Amparo Marco-Martínez ¹ & Bárbara Cánovas ¹

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¹Virgen de la Salud Hospital, Toledo, Spain; ²Hospital Comarcal del noroeste, Caravaca de la Cruz, Spain.

Introduction: Cinacalcet is an oral calcimimetic indicated in treatment of primary hyperparathyroidism if patients do not accept surgery, do not carry out the surgical criteria, there is failure of previous surgery or serious comorbidity that makes surgery impossible.

Methods: Descriptive study that included 20 patients with primary hyperparathyroidism who had complete at least 12 months of treatment with cinacalcet for different reasons (eight patients refusal to parathyroidectomy, three surgery not possible due to comorbidities and nine progressive hypercalcemia prior to surgery). We recorded clinical and biochemical data at baseline, and after 3, 6 and 12 months of treatment.

Results: After 3 months of therapy, serum calcium was significantly decrease (10.7 vs 11.73 mg/dl, P<0.001) and serum phosphorus was significantly increased (2.62 vs 2.41 mg/dl, P=0.004) while no significant change occurred in serum PTH (181.91 vs 195.47 P=0.695). No further variation was observed after 6 months as compared to 3 months follow up. After 12 months serum PTH was significantly decreased as compared to baseline (152.47 vs 181.91, P=0.028) as well as serum calcium (10.2 vs 11.73 mg/dl, P<0.001) and phosphorus levels (2.71 vs 2.41 mg/dl, P=0.01). Normocalcemia (S-Ca <10.1 mg/dl) was achieved in 55% of patients.

Usually the medication was well-tolerated. Most common adverse events were nausea and vomiting, especially at the beginning of therapy.

Conclusion: Hypercalcemia is rapidly improved by cinacalcet and remains stable after 12 months follow-up. Cinacalcet is an effective alternative in non-surgical treatment of primary hyperparathyroidism in patients with recurrent disease or in case of surgical contraindications. Furthermore, cinacalcet may be useful in the preoperative hypercalcemia management.