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Cinacalcet (KRN1493) effectively decreases the serum intact PTH level with favourable control of the serum phosphorus and calcium levels in Japanese dialysis patients

Background. Cinacalcet hydrochloride (KRN1493) acts on the parathyroid calcium receptors to suppress parathyroid hormone (PTH) secretion, and is already in wide use in the United States and the European countries. In this study, we examined the efficacy and safety of cinacalcet in Japanese patients...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2008-01, Vol.23 (1), p.328-335
Main Authors: Fukagawa, Masafumi, Yumita, Shigeru, Akizawa, Tadao, Uchida, Eiji, Tsukamoto, Yusuke, Iwasaki, Manabu, Koshikawa, Shozo
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container_end_page 335
container_issue 1
container_start_page 328
container_title Nephrology, dialysis, transplantation
container_volume 23
creator Fukagawa, Masafumi
Yumita, Shigeru
Akizawa, Tadao
Uchida, Eiji
Tsukamoto, Yusuke
Iwasaki, Manabu
Koshikawa, Shozo
description Background. Cinacalcet hydrochloride (KRN1493) acts on the parathyroid calcium receptors to suppress parathyroid hormone (PTH) secretion, and is already in wide use in the United States and the European countries. In this study, we examined the efficacy and safety of cinacalcet in Japanese patients on maintenance haemodialysis. Methods. One hundred forty-four patients with serum intact PTH (iPTH) levels ≥300 pg/ml were enrolled and randomly allocated to two groups assigned to receive either cinacalcet or placebo for 14 weeks. Cinacalcet was started at the dose of 25 mg/day and titrated up to 100 mg/day to achieve the target iPTH level of
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Cinacalcet hydrochloride (KRN1493) acts on the parathyroid calcium receptors to suppress parathyroid hormone (PTH) secretion, and is already in wide use in the United States and the European countries. In this study, we examined the efficacy and safety of cinacalcet in Japanese patients on maintenance haemodialysis. Methods. One hundred forty-four patients with serum intact PTH (iPTH) levels ≥300 pg/ml were enrolled and randomly allocated to two groups assigned to receive either cinacalcet or placebo for 14 weeks. Cinacalcet was started at the dose of 25 mg/day and titrated up to 100 mg/day to achieve the target iPTH level of &lt;250 pg/ml. Results. Cinacalcet significantly decreased the median iPTH level from 606.5 pg/ml to 241.0 pg/ml, despite the mean dialysis vintage being 2.4 times longer (14.3 ± 7.1 years) and the proportion of patients receiving vitamin D sterols being higher, than in the phase 3 studies conducted in the US/EU. The target iPTH level was achieved in 51.4% of the patients in the cinacalcet group, in sharp contrast to only 2.8% in the placebo group. Furthermore, the percentage of patients with both the serum calcium and phosphorus levels within the target range in the K/DOQI guidelines increased from 4.2% to 26.4% by cinacalcet. Conclusions. These results suggest that lower dose levels of cinacalcet, as compared to those in US/EU studies, may be sufficient effectively suppress the serum iPTH levels and allow favourable management of the serum calcium and phosphorus levels in Japanese patients, having a longer average dialysis vintage.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfm534</identifier><identifier>PMID: 17717030</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; calcimimetics ; calcium ; Calcium - blood ; calcium-sensing receptor ; cinacalcet ; Cinacalcet Hydrochloride ; Double-Blind Method ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Glomerulonephritis ; Humans ; Hyperparathyroidism - blood ; Hyperparathyroidism - drug therapy ; Intensive care medicine ; Japan ; Male ; Medical sciences ; Middle Aged ; Naphthalenes - therapeutic use ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. 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Cinacalcet hydrochloride (KRN1493) acts on the parathyroid calcium receptors to suppress parathyroid hormone (PTH) secretion, and is already in wide use in the United States and the European countries. In this study, we examined the efficacy and safety of cinacalcet in Japanese patients on maintenance haemodialysis. Methods. One hundred forty-four patients with serum intact PTH (iPTH) levels ≥300 pg/ml were enrolled and randomly allocated to two groups assigned to receive either cinacalcet or placebo for 14 weeks. Cinacalcet was started at the dose of 25 mg/day and titrated up to 100 mg/day to achieve the target iPTH level of &lt;250 pg/ml. Results. Cinacalcet significantly decreased the median iPTH level from 606.5 pg/ml to 241.0 pg/ml, despite the mean dialysis vintage being 2.4 times longer (14.3 ± 7.1 years) and the proportion of patients receiving vitamin D sterols being higher, than in the phase 3 studies conducted in the US/EU. The target iPTH level was achieved in 51.4% of the patients in the cinacalcet group, in sharp contrast to only 2.8% in the placebo group. Furthermore, the percentage of patients with both the serum calcium and phosphorus levels within the target range in the K/DOQI guidelines increased from 4.2% to 26.4% by cinacalcet. Conclusions. These results suggest that lower dose levels of cinacalcet, as compared to those in US/EU studies, may be sufficient effectively suppress the serum iPTH levels and allow favourable management of the serum calcium and phosphorus levels in Japanese patients, having a longer average dialysis vintage.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>calcimimetics</subject><subject>calcium</subject><subject>Calcium - blood</subject><subject>calcium-sensing receptor</subject><subject>cinacalcet</subject><subject>Cinacalcet Hydrochloride</subject><subject>Double-Blind Method</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Glomerulonephritis</subject><subject>Humans</subject><subject>Hyperparathyroidism - blood</subject><subject>Hyperparathyroidism - drug therapy</subject><subject>Intensive care medicine</subject><subject>Japan</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Naphthalenes - therapeutic use</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>calcimimetics</topic><topic>calcium</topic><topic>Calcium - blood</topic><topic>calcium-sensing receptor</topic><topic>cinacalcet</topic><topic>Cinacalcet Hydrochloride</topic><topic>Double-Blind Method</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Glomerulonephritis</topic><topic>Humans</topic><topic>Hyperparathyroidism - blood</topic><topic>Hyperparathyroidism - drug therapy</topic><topic>Intensive care medicine</topic><topic>Japan</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Naphthalenes - therapeutic use</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Parathyroid Hormone - blood</topic><topic>phosphorus</topic><topic>Phosphorus - blood</topic><topic>PTH</topic><topic>Renal Dialysis</topic><topic>secondary hyperparathyroidism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fukagawa, Masafumi</creatorcontrib><creatorcontrib>Yumita, Shigeru</creatorcontrib><creatorcontrib>Akizawa, Tadao</creatorcontrib><creatorcontrib>Uchida, Eiji</creatorcontrib><creatorcontrib>Tsukamoto, Yusuke</creatorcontrib><creatorcontrib>Iwasaki, Manabu</creatorcontrib><creatorcontrib>Koshikawa, Shozo</creatorcontrib><creatorcontrib>KRN1493 study group</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fukagawa, Masafumi</au><au>Yumita, Shigeru</au><au>Akizawa, Tadao</au><au>Uchida, Eiji</au><au>Tsukamoto, Yusuke</au><au>Iwasaki, Manabu</au><au>Koshikawa, Shozo</au><aucorp>KRN1493 study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cinacalcet (KRN1493) effectively decreases the serum intact PTH level with favourable control of the serum phosphorus and calcium levels in Japanese dialysis patients</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2008-01-01</date><risdate>2008</risdate><volume>23</volume><issue>1</issue><spage>328</spage><epage>335</epage><pages>328-335</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. Cinacalcet hydrochloride (KRN1493) acts on the parathyroid calcium receptors to suppress parathyroid hormone (PTH) secretion, and is already in wide use in the United States and the European countries. In this study, we examined the efficacy and safety of cinacalcet in Japanese patients on maintenance haemodialysis. Methods. One hundred forty-four patients with serum intact PTH (iPTH) levels ≥300 pg/ml were enrolled and randomly allocated to two groups assigned to receive either cinacalcet or placebo for 14 weeks. Cinacalcet was started at the dose of 25 mg/day and titrated up to 100 mg/day to achieve the target iPTH level of &lt;250 pg/ml. Results. Cinacalcet significantly decreased the median iPTH level from 606.5 pg/ml to 241.0 pg/ml, despite the mean dialysis vintage being 2.4 times longer (14.3 ± 7.1 years) and the proportion of patients receiving vitamin D sterols being higher, than in the phase 3 studies conducted in the US/EU. The target iPTH level was achieved in 51.4% of the patients in the cinacalcet group, in sharp contrast to only 2.8% in the placebo group. Furthermore, the percentage of patients with both the serum calcium and phosphorus levels within the target range in the K/DOQI guidelines increased from 4.2% to 26.4% by cinacalcet. Conclusions. These results suggest that lower dose levels of cinacalcet, as compared to those in US/EU studies, may be sufficient effectively suppress the serum iPTH levels and allow favourable management of the serum calcium and phosphorus levels in Japanese patients, having a longer average dialysis vintage.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>17717030</pmid><doi>10.1093/ndt/gfm534</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source Oxford Journals Online
subjects Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
calcimimetics
calcium
Calcium - blood
calcium-sensing receptor
cinacalcet
Cinacalcet Hydrochloride
Double-Blind Method
Emergency and intensive care: renal failure. Dialysis management
Female
Glomerulonephritis
Humans
Hyperparathyroidism - blood
Hyperparathyroidism - drug therapy
Intensive care medicine
Japan
Male
Medical sciences
Middle Aged
Naphthalenes - therapeutic use
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Parathyroid Hormone - blood
phosphorus
Phosphorus - blood
PTH
Renal Dialysis
secondary hyperparathyroidism
title Cinacalcet (KRN1493) effectively decreases the serum intact PTH level with favourable control of the serum phosphorus and calcium levels in Japanese dialysis patients
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