Impact of etelcalcetide on fibroblast growth factor‐23 and calciprotein particles in patients with secondary hyperparathyroidism undergoing haemodialysis
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Media type:
E-Article
Title:
Impact of etelcalcetide on fibroblast growth factor‐23 and calciprotein particles in patients with secondary hyperparathyroidism undergoing haemodialysis
Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Recently, we demonstrated the efficacy of etelcalcetide in the control of secondary hyperparathyroidism (SHPT). This <jats:italic>post hoc</jats:italic> analysis aimed to evaluate changes in fibroblast growth factor‐23 (FGF23) and calciprotein particles (CPPs) after treatment with calcimimetics.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The DUET trial was a 12‐week multicenter, open‐label, parallel‐group, randomized (1:1:1) study with patients treated with etelcalcetide plus active vitamin D (E + D group; <jats:italic>n</jats:italic> = 41), etelcalcetide plus oral calcium (E + Ca group; <jats:italic>n</jats:italic> = 41), or control (C group; <jats:italic>n</jats:italic> = 42) under maintenance haemodialysis. Serum levels of FGF23 and CPPs were measured at baseline, and 6 and 12 weeks after the start.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the linear mixed model, serum levels of FGF23 in etelcalcetide users were significantly lower than those in non‐users at week 6 (<jats:italic>p</jats:italic> < .001) and week 12 (<jats:italic>p</jats:italic> < .001). When compared the difference between the E + Ca group and the E + D group, serum levels of FGF23 in the E + Ca group were significantly lower than those in the E + D group at week 12 (<jats:italic>p</jats:italic> = .017). There were no significant differences in the serum levels of CPPs between etelcalcetide users and non‐users at week 6 and week 12, while CPPs in the E + Ca group were significantly lower than those in the E + D group (<jats:italic>p</jats:italic> < .001) at week 12.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Etelcalcetide may be useful through suppression of FGF23 levels among haemodialysis patients with SHPT. When correcting hypocalcaemia, loading oral calcium preparations could be more advantageous than active vitamin D for the suppression of both FGF23 and CPPs.</jats:p></jats:sec>