The association between cinacalcet use and missed in-center hemodialysis treatment rate

Purpose Missed in‐center hemodialysis treatments (MHT) are a general indicator of health status in hemodialysis patients. This analysis was conducted to estimate the association between cinacalcet use and MHT rate. Methods We studied patients receiving hemodialysis and prescription benefits services...

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Bibliographic Details
Published in:Pharmacoepidemiology and drug safety 2016-11, Vol.25 (11), p.1287-1294
Main Authors: Brunelli, Steven M., Sibbel, Scott, Dluzniewski, Paul J., Cooper, Kerry, Bensink, Mark E., Bradbury, Brian D.
Format: Article
Language:English
Subjects:
adherence
Adult
Aged
Calcimimetic Agents - administration & dosage
Calcium - blood
Cinacalcet Hydrochloride - administration & dosage
dialysis
Health Status
Hemodialysis
Humans
Kidney Failure, Chronic - therapy
Male
Medicare
Middle Aged
outcomes
Parathyroid Hormone - blood
pharmacoepidemiology
Pharmacology
Phosphorus - blood
Renal Dialysis - statistics & numerical data
Retrospective Studies
Vitamin D - administration & dosage
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Summary:Purpose Missed in‐center hemodialysis treatments (MHT) are a general indicator of health status in hemodialysis patients. This analysis was conducted to estimate the association between cinacalcet use and MHT rate. Methods We studied patients receiving hemodialysis and prescription benefits services from a large dialysis organization. Incident cinacalcet users were propensity score matched to controls on 31 demographic, clinical, and laboratory variables. We applied inverse probability (IP) of censoring and crossover weights to account for informative censoring. Weighted negative binomial modeling was used to estimate MHT rates and pooled logistics models were used to estimate the association between cinacalcet use and MHT. Results Baseline demographic and clinical variables included serum calcium, phosphorus, parathyroid hormone, and vitamin D use, and were balanced between 15,474 new cinacalcet users and 15,474 matched controls. In an analysis based on intention‐to‐treat principles, 40.8% of cinacalcet users and 46.5% of nonusers were censored. MHT rate was 13% lower among cinacalcet initiators versus controls: IP of censoring weighted incidence rate ratio was 0.87 (95% confidence interval [CI]: 0.84–0.90 p 
ISSN:1053-8569
1099-1557
DOI:10.1002/pds.4050