Limits...
Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism.

Moyes VJ, Monson JP, Chew SL, Akker SA - Int J Endocrinol (2010)

Bottom Line: Significant reductions were observed in serum calcium and PTH measurements.Conclusion.Cinacalcet is an effective and well-tolerated medical treatment for the management of complex primary hyperparathyroidism.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, UK.

ABSTRACT
Background. Management of multiple-endocrine neoplasia type 1- (MEN1-) associated hyperparathyroidism is associated with high recurrence rates and high surgical morbidity due to multiple neck explorations. Cinacalcet, a calcimimetic agent licensed for the treatment of secondary hyperparathyroidism and parathyroid carcinoma, may provide a medical alternative for the management of these complex patients. Methods. A prospective audit was performed of eight patients; three males and five females, aged 20-38 at diagnosis. Two patients commenced cinacalcet as primary treatment and six had previous surgery. Six patients had complications of hyperparathyroidism: renal calculi, renal dysfunction, and reduced bone mineral density. All were commenced on cinacalcet 30 mg bd for MEN1 associated hyperparathyroidism; doses were subsequently reduced to 30 mg od in four patients. Results. Significant reductions were observed in serum calcium and PTH measurements. Serum calcium reduced by a median of 0.35 mmol/L (P = .012 Wilcoxon Signed Rank). Serum PTH levels decreased by a median of 5.05 pmol/L (P = .012). There was no change in urine calcium. Duration ranged from 10-35 months with maintenance of control. Cinacalcet was well tolerated by six patients; one experienced nausea and one experienced diarrhoea. Conclusion. Cinacalcet is an effective and well-tolerated medical treatment for the management of complex primary hyperparathyroidism.

No MeSH data available.


Related in: MedlinePlus

Change in biochemical parameters pre- and post commencement of cinacalcet. These graphs demonstrate the change in serum calcium and serum PTH pre- and post commencement of cinacalcet. Each line represents an individual patients' data. The grey dotted line indicates the normal reference range.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2877200&req=5

fig1: Change in biochemical parameters pre- and post commencement of cinacalcet. These graphs demonstrate the change in serum calcium and serum PTH pre- and post commencement of cinacalcet. Each line represents an individual patients' data. The grey dotted line indicates the normal reference range.

Mentions: All patients achieved normocalcaemia on cinacalcet with a median posttreatment serum corrected calcium of 2.35 mmol/L, range of 2.13–2.54 mmol/L. Serum calcium reduced by a median of 0.68 mmol/L, range of 0.10–0.68 mmol/L, and was statistically significant (P = .012) (Figure 1(a)). Serum PTH reduced by median of 5.05 pmol/L, range of 0.7–24.8 pmol/L, (P = .012) (Figure 1(b)). Analyses were repeated following removal of a potential outlier (patient number 8) to confirm statistical significance; this confirmed a significant reduction in serum PTH (P = .018). A significant increase was noted in serum phosphate (P = .012) but no change was found in 24-hour urinary calcium measurements (Table 2).


Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism.

Moyes VJ, Monson JP, Chew SL, Akker SA - Int J Endocrinol (2010)

Change in biochemical parameters pre- and post commencement of cinacalcet. These graphs demonstrate the change in serum calcium and serum PTH pre- and post commencement of cinacalcet. Each line represents an individual patients' data. The grey dotted line indicates the normal reference range.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2877200&req=5

fig1: Change in biochemical parameters pre- and post commencement of cinacalcet. These graphs demonstrate the change in serum calcium and serum PTH pre- and post commencement of cinacalcet. Each line represents an individual patients' data. The grey dotted line indicates the normal reference range.
Mentions: All patients achieved normocalcaemia on cinacalcet with a median posttreatment serum corrected calcium of 2.35 mmol/L, range of 2.13–2.54 mmol/L. Serum calcium reduced by a median of 0.68 mmol/L, range of 0.10–0.68 mmol/L, and was statistically significant (P = .012) (Figure 1(a)). Serum PTH reduced by median of 5.05 pmol/L, range of 0.7–24.8 pmol/L, (P = .012) (Figure 1(b)). Analyses were repeated following removal of a potential outlier (patient number 8) to confirm statistical significance; this confirmed a significant reduction in serum PTH (P = .018). A significant increase was noted in serum phosphate (P = .012) but no change was found in 24-hour urinary calcium measurements (Table 2).

Bottom Line: Significant reductions were observed in serum calcium and PTH measurements.Conclusion.Cinacalcet is an effective and well-tolerated medical treatment for the management of complex primary hyperparathyroidism.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, UK.

ABSTRACT
Background. Management of multiple-endocrine neoplasia type 1- (MEN1-) associated hyperparathyroidism is associated with high recurrence rates and high surgical morbidity due to multiple neck explorations. Cinacalcet, a calcimimetic agent licensed for the treatment of secondary hyperparathyroidism and parathyroid carcinoma, may provide a medical alternative for the management of these complex patients. Methods. A prospective audit was performed of eight patients; three males and five females, aged 20-38 at diagnosis. Two patients commenced cinacalcet as primary treatment and six had previous surgery. Six patients had complications of hyperparathyroidism: renal calculi, renal dysfunction, and reduced bone mineral density. All were commenced on cinacalcet 30 mg bd for MEN1 associated hyperparathyroidism; doses were subsequently reduced to 30 mg od in four patients. Results. Significant reductions were observed in serum calcium and PTH measurements. Serum calcium reduced by a median of 0.35 mmol/L (P = .012 Wilcoxon Signed Rank). Serum PTH levels decreased by a median of 5.05 pmol/L (P = .012). There was no change in urine calcium. Duration ranged from 10-35 months with maintenance of control. Cinacalcet was well tolerated by six patients; one experienced nausea and one experienced diarrhoea. Conclusion. Cinacalcet is an effective and well-tolerated medical treatment for the management of complex primary hyperparathyroidism.

No MeSH data available.


Related in: MedlinePlus