Effects of cinacalcet: A Synthesis of Findings from 14 Studies

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Original Abstract of the Article

Major Research Findings

Cinacalcet, a calcimimetic medication, has shown promising effects in managing secondary hyperparathyroidism, a condition often associated with chronic kidney disease and dialysis. Research suggests that cinacalcet can reduce the risk of death or cardiovascular events in older patients with moderate to severe secondary hyperparathyroidism who are on hemodialysis. However, this benefit may not extend to younger patients. 13 Further studies have investigated the acute effects of cinacalcet on arterial stiffness and ventricular function in hemodialysis patients, indicating a potential role in improving vascular health. 8 Cinacalcet has also been explored for its therapeutic potential in post-transplant hypercalcemia and hyperparathyroidism, offering an alternative to surgery. 2 Additionally, cinacalcet has demonstrated a positive impact on bone mineral metabolism, potentially aiding in the management of anemia and reducing left ventricular mass index in hemodialysis patients. 11

Benefits and Risks

Benefit Summary

Cinacalcet shows potential benefits for patients with secondary hyperparathyroidism, particularly older individuals on hemodialysis. It may reduce the risk of death or cardiovascular events, improve arterial stiffness and ventricular function, and offer an alternative treatment for post-transplant hypercalcemia and hyperparathyroidism. It may also contribute to better bone health, anemia management, and reduced left ventricular mass in hemodialysis patients. 13 8 2 11

Risk Summary

While generally considered safe, cinacalcet can have side effects, such as nausea, vomiting, constipation, indigestion, low calcium levels, low phosphorus levels, high magnesium levels, and prolonged QT interval. It can also interact with other medications. Therefore, it is crucial to consult with your doctor before starting cinacalcet.

Comparison Between Studies

Commonalities

Several studies highlight the potential benefits of cinacalcet in treating hyperparathyroidism. There's a consistent theme across the research demonstrating that cinacalcet can influence heart health, blood pressure, anemia, bone metabolism, and potentially reduce the risk of fractures.

Differences

The effects of cinacalcet may vary depending on the age, kidney function, and other factors of the patient. Additionally, research methodologies and study populations can influence the results. For example, a study found cinacalcet effectively reduced cardiovascular risks in older patients but not younger ones. 13 Furthermore, the drug's impact on bone health remains an area of ongoing investigation, and further research is needed to confirm its benefits in this area.

Consistency and Contradictions

While the research suggests positive outcomes with cinacalcet, it's important to remember that results can differ due to patient characteristics and study design. Further investigation is required to understand the specific impact of cinacalcet on various patient demographics and to refine the understanding of its efficacy.

Practical Implications

Cinacalcet could offer a valuable treatment option for patients with secondary hyperparathyroidism, particularly those on hemodialysis. However, it's crucial to be aware of potential side effects and to discuss these with your doctor before starting treatment. Cinacalcet may interact with other medications, so proper medical guidance is essential.

Limitations of Current Research

More research is needed to fully understand the long-term effects and safety profile of cinacalcet. Further studies are also necessary to explore the impact of cinacalcet on different patient groups, such as those with varying ages or kidney function. The interactions between cinacalcet and other therapies require additional investigation to optimize patient outcomes.

Future Research Directions

Future research should focus on the long-term efficacy and safety of cinacalcet, analyzing its effects on patients with varying characteristics. Research should also explore the potential benefits of combining cinacalcet with other treatments to enhance therapeutic outcomes.

Conclusion

Cinacalcet shows promise as a therapeutic option for patients with secondary hyperparathyroidism, particularly older adults on hemodialysis. It may reduce the risk of death or cardiovascular events and offer benefits for bone health, anemia management, and blood pressure control. However, cinacalcet can have side effects and may interact with other medications. It is essential to consult with your doctor to determine if cinacalcet is a suitable treatment option and to discuss any concerns or potential risks.

Literature analysis of 14 papers
Positive Content
13
Neutral Content
0
Negative Content
1
Article Type
7
0
0
0
14
1.

Effects of calcium carbonate, sevelamer hydrochloride or pantoprazole on the pharmacokinetics of cinacalcet.

Author: PadhiDesmond, HarrisRobert, SullivanJohn T

Secondary hyperparathyroidism treatment

This study assessed the effects of calcium carbonate, sevelamer hydrochloride, and pantoprazole sodium on the pharmacokinetics and safety of cinacalcet in healthy subjects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Evaluating the clinical and mechanistic effects of eplerenone and amiloride monotherapy, and combination therapy with cinacalcet, in primary hyperparathyroidism: A placebo-controlled randomized trial.

Author: ParksookWasita W, HeydarpourMahyar, BrownJenifer M, TurchinAlexander, MannstadtMichael, VaidyaAnand

Hyperparathyroidism treatment

Eplerenone, a mineralocorticoid receptor antagonist, may lower parathyroid hormone (PTH) levels in patients with primary hyperparathyroidism, suggesting its potential for managing PTH levels in these patients.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Label-Free Mass Spectrometry-Based Quantitative Proteomics to Evaluate the Effects of the Calcium-Sensing Receptor Agonist Cinacalcet on Protein Expression in Rat Brains and Livers.

Author: BulskaEwa, GaworAndrzej, KonopkaAnna, WrykGrzegorz, Czarkowska-PączekBożena, GajewskiZdzisław, PączekLeszek

Cognitive dysfunction
Detoxication impairment

Long-term cinacalcet therapy may affect protein expression in rat brains and livers, potentially disrupting detoxication, hemostasis, lipid metabolism, and inflammatory mediators.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Effects of Cinacalcet and Parathyroidectomy on Blood Pressure in Maintenance Hemodialysis Patients with Secondary Hyperparathyroidism.

Author: WangMengjing, WenDonghai, ZhangWeichen, ChenWeisheng, TaoYe, FanChunyan, HuangBihong, ChenJing, WangHongying, ZhangMinmin

Blood pressure control

This study observed the effects of different treatment modalities of hyperparathyroidism on blood pressure among maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism. Secondary hyperparathyroidism may cause an increase in blood pressure among MHD patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

A randomised controlled trial to examine the effects of cinacalcet on bone and cardiovascular parameters in haemodialysis patients with advanced secondary hyperparathyroidism.

Author: EddingtonHelen, ChinnaduraiRajkumar, AldersonHelen, IbrahimSara T, ChrysochouConstantina, GreenDarren, ErekosimaIbi, HutchisonAlastair, BubtanaAbdalla, HegartyJanet, KalraPhilip A

CKD-MBD management
Cinacalcet
Secondary hyperparathyroidism

An open-label prospective randomized controlled trial of 36 haemodialysis patients with secondary hyperparathyroidism found no significant benefit in bone and cardiovascular markers with the addition of cinacalcet to standard therapy over one year. However, tight control of hyperphosphataemia and secondary hyperparathyroidism may lead to a reduction in left ventricular mass index and carotid intima-media thickness, but this needs further investigation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Effects of Long-Term Cinacalcet Administration on Parathyroid Gland in Hemodialysis Patients with Secondary Hyperparathyroidism.

Author: OkunoSenji, InabaMasaaki, IshimuraEiji, NakataniShinya, ChouHidenori, ShojiShigeichi, YamakawaTomoyuki

Intact PTH reduction
Parathyroid gland volume reduction
Phosphate reduction

Long-term treatment with cinacalcet significantly decreased parathyroid gland volume and serum levels of intact PTH and phosphate in hemodialysis patients with secondary hyperparathyroidism, suggesting its potential to postpone the need for parathyroidectomy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

8.

Acute effects of cinacalcet on arterial stiffness and ventricular function in hemodialysis patients: A randomized double-blinded crossover study.

Author: PoulinAurélie, BellemarePierre-Luc, FortierCatherine, Mac-WayFabrice, DesmeulesSimon, MarquisKarine, GaudreaultValérie, LebelMarcel, AgharaziiMohsen

Improved myocardial diastolic function
Improved vascular stiffness

This study examined whether acutely lowering serum calcium concentration (Ca) by cinacalcet, a calcimimetic, could improve vascular stiffness and myocardial diastolic dysfunction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Effects of cinacalcet treatment on QT interval in hemodialysis patients.

Author: TemizGökhan, YalçınAhmet Uğur, MutluayRüya, Bozacıİlter, BalCengiz

Lowered calcium and phosphorus levels
Lowered parathormone levels
QT prolongation

This study aimed to evaluate the effects of cinacalcet on the QT interval in patients with end-stage renal disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

The effects of cinacalcet on blood pressure, mortality and cardiovascular endpoints in the EVOLVE trial.

Author: ChangT I, AbdallaS, LondonG M, BlockG A, Correa-RotterR, DrüekeT B, FloegeJ, HerzogC A, MahaffeyK W, MoeS M, ParfreyP S, WheelerD C, DehmelB, GoodmanW G, ChertowG M

Cardiovascular event prevention

Cinacalcet treatment in patients with secondary hyperparathyroidism (sHPT) and end-stage renal disease was associated with a lower risk of death and major cardiovascular events and a significant decrease in blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

The Effects of Cinacalcet in Older and Younger Patients on Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial.

Author: ParfreyPatrick S, DrüekeTilman B, BlockGeoffrey A, Correa-RotterRicardo, FloegeJürgen, HerzogCharles A, LondonGerard M, MahaffeyKenneth W, MoeSharon M, WheelerDavid C, KuboYumi, DehmelBastian, GoodmanWilliam G, ChertowGlenn M,

Reduced risk of death or CV events

This study investigated the effects of the calcimimetic cinacalcet on the risk of death or cardiovascular (CV) events in patients with secondary hyperparathyroidism (HPT). Cinacalcet was found to reduce this risk in older patients, but not in younger patients, potentially due to differences in baseline CV risk and use of cointerventions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Effects of Cinacalcet on Fracture Events in Patients Receiving Hemodialysis: The EVOLVE Trial.

Author: MoeSharon M, AbdallaSafa, ChertowGlenn M, ParfreyPatrick S, BlockGeoffrey A, Correa-RotterRicardo, FloegeJürgen, HerzogCharles A, LondonGerard M, MahaffeyKenneth W, WheelerDavid C, DehmelBastian, GoodmanWilliam G, DrüekeTilman B,

Fracture prevention
Hemodialysis treatment

This study tested the hypothesis that cinacalcet would reduce the rate of clinical fractures in patients receiving hemodialysis using data from the Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events trial.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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