[Commentary on] The OPTIMA study: assessing a new cinacalcet (sensipar/mimpara) treatment algorithm for secondary hyperparathyroidism.
Background and objective: Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower parathyroid hormone (PTH), calcium, and phosphorus levels in dialysis patients with secondary hyperparathyroidism (SHPT). This study compared the efficacy of a cinacalcet-based regimen with unre...
| Published in: | Indian Journal of Nephrology Vol. 18; no. 1; pp. 42 - 43 |
|---|---|
| Format: | abstract commentary Journal Article |
| Published: |
Scientific Scholar LLC
Jan-Mar2008
|
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105543744&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105543744 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09714065 1CQK jtl: Indian Journal of Nephrology issn: 09714065 maglogo: N pubinfo: dt: Jan-Mar2008 vid: 18 iid: 1 pid: 56013 pub: Scientific Scholar LLC place: Pittsford, New York artinfo: ui: 105543744 105543744 2010301063 105543744 ppf: 42 ppct: 1 formats: tig: atl: [Commentary on] The OPTIMA study: assessing a new cinacalcet (sensipar/mimpara) treatment algorithm for secondary hyperparathyroidism. aug: sug: subj: Hydrocarbons Administration and Dosage Hyperparathyroidism Drug Therapy Kidney Failure, Chronic Complications Calcium Blood Chelating Agents Adverse Effects Phosphorus Blood Treatment Outcomes Vitamin D Administration and Dosage Vitamin D Adverse Effects ab: Background and objective: Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower parathyroid hormone (PTH), calcium, and phosphorus levels in dialysis patients with secondary hyperparathyroidism (SHPT). This study compared the efficacy of a cinacalcet-based regimen with unrestricted conventional care (vitamin D and phosphate binders) for achieving the stringent National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) targets for dialysis patients. Study design: In this multicenter, open-label study, haemodialysis patients with poorly controlled SHPT were randomized to receive conventional care (n=184) or a cinacalcet-based regimen (n=368). Doses of cinacalcet, vitamin D sterols, and phosphate binders were adjusted during a 16-wk dose-optimization phase with the use of algorithms that allowed cinacalcet to be used with adjusted doses of vitamin D. The primary end point was the proportion of patients with mean intact PTH<300 pg/ml during a 7-wk efficacy assessment phase. Results: A higher proportion of patients receiving the cinacalcet-based regimen versus conventional care achieved the targets for PTH (71% versus 22%, respectively ; P<0.001), Ca*P(77% versus 58%, respectively; P<0.001), calcium (76% versus 33%, respectively; P<0.001), phosphorus (63% versus 50%, respectively; P=0.002), and PTH and Ca*P (59% versus 16%, respectively, P<0.001), and allowed a 22% reduction in vitamin D dosage in patients receiving vitamin D at baseline. Achievement of targets was greatest in patients with less severe disease (intact PTH range, 300 to 500 pg/ml) and the cinacalcet dose required was lower in these patients (median = 30 mg/d). Conclusions: Compared with conventional therapy, a cinacalcet-based treatment algorithm increased achievement of KDOQI treatment targets in dialysis patients in whom conventional therapy was no longer effective in controlling this disease. pubtype: Academic Journal doctype: abstract commentary Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|