ArticleProblemy endokrinologii2026
[Switching patients from cinacalcet to etelcalcetide: evaluation of predictors of efficacy in a retrospective cohort study].
Article in Problemy endokrinologii, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prevalence of SHPT depends on control strategy and target level of PTH. There is insufficient data for a justified choice of goals and strategy for the SHPT correction.
aimA retrospective, multicenter, cohort study was conducted to assess the ethelcalcetide efficacy after six months in real world practice. The study sought to identify whether MBD-CKD characteristics are predictive of achieving the goals. MATERIALS AND
methodsA study included 302 patients in 20 dialysis units in St. Petersburg. The primary endpoint was the proportion of patients who reached the target of PTH (300-599 pg/ml). The secondary endpoint was an absolute and relative decrease in PTH. The results were compared in subgroups with PTH (<600, 600-1000, ≥1000 pg/ml) and with and without signs of parathyroid authonomy.
resultsIn patients aged 56 (12) years (men - 61%) with a dialysis duration of 36 (Q1-Q3 23-55) months with baseline PTH level of 729 (548-957) pg/ml and with calcemia and phosphatemia 2.35 (0.25) and 1.97 (0.47) mM/L, the proportion of success was 49.7%. It is more expected for the PTH of 600-1000 pg/ml compared with PTH>1000 pg/ml: 79% vs. 36%, p<0.001. In presence of signs of parathyroid authonomy, 48% reached the target range vs. 86% in its absence (p<0.001) in subgroup with PTH of 600-1000 pg/ml. For patients with PTH above 1000 pg/ml, the proportion was 25% vs. 58% (p=0.016). The signs of parathyroid authonomy was the most significant independent risk for target achieving (OR=0.3 [95% CI 0.13; 0.68], p=0.004)
conclusionWhen transferring patients from cinacalcet to etelcalcetide, no new side effects or drug intolerance were noted. In moderate SHPT (PTH 600-1000 pg/ml) it is possible to achieve the target in most patients, but with higher level, the result worsened. The signs of parathyroid authonomy predicts the insufficient effect better than high baseline PTH level.
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