Cinacalcet to prevent parathyrotoxic crises in hypercalcaemic patients awaiting parathyroidectomy

Rostoker, Guy; Bellamy, J; Janklewicz, Philippe

doi:10.1136/bcr.12.2010.3663

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…There was no difference in spine BMD at 52 weeks, and in a 4.5-year cross-over open label extension study conducted in 45 patients of the original cohort all given cinacalcet, there was no significant change in BMD at LS, hip or distal radius [ 90 ]. Similar efficacy of cinacalcet on serum calcium normalization was reported in patients with intractable PHPT [ 91 ], symptomatic severe hypercalcemia [ 92 ] and parathyroid carcinoma [ 93 , 94 ], suggesting significant benefit across a broad spectrum of disease severity.…”

Section: Pharmacologic Interventionsupporting

confidence: 56%

Primary Hyperparathyroidism: A Narrative Review of Diagnosis and Medical Management

Dandurand

Ali

Khan

2021

JCM

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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia in the outpatient setting. Symptomatic presentation includes non-specific signs and symptoms of hypercalcemia, skeletal fragility, nephrolithiasis and nephrocalcinosis. The majority of individuals present at an asymptomatic stage following routine biochemical screening, without any signs or symptoms of calcium or parathyroid hormone (PTH) excess or target organ damage. Indications for surgery have recently been revised as published in recent guidelines and consensus statements. Parathyroidectomy is advised in patients younger than 50 years old and in the presence of either significant hypercalcemia, impaired renal function, renal stones or osteoporosis. Surgery is always appropriate in suitable surgical candidates, however, medical management may be considered in those with mild asymptomatic disease, contraindications to surgery or failed previous surgical intervention. We summarized the optimal medical interventions available in the care of PHPT patients not undergoing parathyroidectomy. Calcium and vitamin D intake should be optimized. Antiresorptive therapy may be used for skeletal protection in patients with an increased fracture risk. Cinacalcet, a calcimimetic agent, has been shown to effectively lower serum calcium and PTH levels. The effect of medical treatment on the reduction in fracture risk is unknown and should be the focus of future research.

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Section: Pharmacologic Interventionsupporting

confidence: 56%

Primary Hyperparathyroidism: A Narrative Review of Diagnosis and Medical Management

Dandurand

Ali

Khan

2021

JCM

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“…94 Serum calcium normalized within 1 week of therapy in two patients and fell to a safe level in the third. Parathyroidectomy was successfully performed within several weeks of diagnosis.…”

Section: Intractable Phpt and Parathyroid Carcinomamentioning

confidence: 97%

Medical Management of Primary Hyperparathyroidism

Marcocci

Khan

2015

The Parathyroids

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“…Cinacalcet 12,13 , a calcimimetic agent, has been used to lower the calcium levels in people with sporadic and familial primary hyperparathyroidism. Cinacalcet only lowers the serum calcium and does not reduce the risk of complications from primary hyperparathyroidism such as nephrocalcinosis, hypercalciuria and reduced bone mineral density.…”

Section: What Further Investigations Are Required?mentioning

confidence: 99%

Problem based review: The patient with hypercalcaemia

Machenahalli

Shotliff

2015

Acute Med

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Hypercalcaemia is a common problem which may present to the Acute Medical Unit. Primary hyperparathyroidism (PHPT) and malignancy are the commonest causes of hypercalcaemia, accounting for over 90% of cases. Assessment of parathyroid hormone (PTH) levels is key to determining whether hypercalcaemia is parathyroid-mediated. Initial systematic assessment and adequate rehydration are important to help make the underlying diagnosis and determine longer-term management. The medical management of primary hyperparathyroidism not requiring surgery, with Cinacalcet is highlighted.

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Cinacalcet to prevent parathyrotoxic crises in hypercalcaemic patients awaiting parathyroidectomy

Cited by 6 publications

References 5 publications

Primary Hyperparathyroidism: A Narrative Review of Diagnosis and Medical Management

Primary Hyperparathyroidism: A Narrative Review of Diagnosis and Medical Management

Medical Management of Primary Hyperparathyroidism

Problem based review: The patient with hypercalcaemia

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