Evocalcet: A New Oral Calcimimetic for Dialysis Patients With Secondary Hyperparathyroidism

Akizawa, Tadao; Ikejiri, Kazuaki; Kondo, Yuichiro; Endo, Yuki; Fukagawa, Masafumi

doi:10.1111/1744-9987.13434

Cited by 25 publications

(24 citation statements)

References 48 publications

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“…9 A relatively new calcimimetic agent, evocalcet, decreases PTH levels in a manner similar to that of cinacalcet, but with a lower frequency of upper gastrointestinal ADRs. [13][14][15][16][17][18][19][20] Therefore, evocalcet is likely to be beneficial for patients who cannot take higher cinacalcet dosages and/or those with low adherence to cinacalcet treatment because of ADRs. Because evocalcet was approved for SHPT, some patients start treatment with evocalcet without prior cinacalcet use (cinacalcet nonusers), whereas others switch from cinacalcet to evocalcet (cinacalcet users).…”

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confidence: 99%

Efficacy of Evocalcet in Previously Cinacalcet-Treated Secondary Hyperparathyroidism Patients

Koiwa

Tokunaga

Asada

et al. 2021

Kidney International Reports

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Introduction: Evocalcet is a recently approved calcimimetic agent for secondary hyperparathyroidism (SHPT). In this study, the efficacy and safety of once-daily oral evocalcet were evaluated in patients without prior cinacalcet use (nonusers) and previously treated patients (users).Methods: This post hoc analysis of a previous phase III head-to-head comparison study included SHPT patients treated with evocalcet with or without prior cinacalcet use. Endpoints included trends in the median intact and whole parathyroid hormone (PTH), mean corrected calcium, phosphate, and bone metabolic markers, and whole-to-intact PTH ratios throughout the 30-week study period; proportions of patients achieving target intact PTH, corrected calcium, and phosphate at weeks 28 to 30; and adverse drug reactions (ADRs).Results: This study included 127 nonusers and 190 users with significant differences in age; duration of dialysis; use of intravenous vitamin D receptor activators; levels of intact PTH, corrected calcium, tartrateresistant acid phosphatase 5b, procollagen type 1 N-terminal-propeptide; and largest parathyroid gland volume (P < 0.05 for all characteristics) between 2 groups at baseline. Users required higher evocalcet dosages than nonusers. Similar efficacy results were found in the 2 groups except for a significantly higher proportion of nonusers achieving the intact PTH target (81.6% vs 67.1%, difference [95% confidence interval], À14.5% [À24.59, À3.34]), and a significant reduction in largest parathyroid gland volume from week 0 to week 30 (À120.6 [567.2] mm 3 , P ¼ 0.043). No difference was found in ADRs between the 2 groups. Conclusion:Treatment with evocalcet is effective and safe irrespective of prior cinacalcet treatment in SHPT patients.

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confidence: 99%

Efficacy of Evocalcet in Previously Cinacalcet-Treated Secondary Hyperparathyroidism Patients

Koiwa

Tokunaga

Asada

et al. 2021

Kidney International Reports

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“…It was developed in pursuit of a molecule capable of effectively managing PTH levels while avoiding the undesirable gastrointestinal effects associated with the use of cinacalcet 50 . Several studies point out that, similarly to cinacalcet, evocalcet binds to the transmembrane domain of the CaSR 51 .…”

Section: Recent Advances In the Management Of Secondary Hyperparathyrmentioning

confidence: 99%

Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease

Rodríguez‐Ortiz

Rodríguez

2020

F1000Res

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Secondary hyperparathyroidism is a complex pathology that develops as chronic kidney disease progresses. The retention of phosphorus and the reductions in calcium and vitamin D levels stimulate the synthesis and secretion of parathyroid hormone as well as the proliferation rate of parathyroid cells. Parathyroid growth is initially diffuse but it becomes nodular as the disease progresses, making the gland less susceptible to be inhibited. Although the mechanisms underlying the pathophysiology of secondary hyperparathyroidism are well known, new evidence has shed light on unknown aspects of the deregulation of parathyroid function. Secondary hyperparathyroidism is an important feature of chronic kidney disease–mineral and bone disorder and plays an important role in the development of bone disease and vascular calcification. Thus, part of the management of chronic kidney disease relies on maintaining acceptable levels of mineral metabolism parameters in an attempt to slow down or prevent the development of secondary hyperparathyroidism. Here, we will also review the latest evidence regarding several aspects of the clinical and surgical management of secondary hyperparathyroidism.

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“…1,2 Vitamin D and its analogs are administrated for early SHPT, whereas parathyroidectomy is the standard approach for severe drug-resistant SHPT. [3][4][5][6][7][8] Microwave ablation, as a minimally invasive therapeutic approach causing parathyroid cells to lose their endocrine functionality, has been increasingly used to treat SHPT. [9][10][11][12][13] Our preliminary study also shows that microwave ablation could be an alternative for secondary hyperparathyroidism in patients with maintenance hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcomes of microwave ablation for secondary hyperparathyroidism in maintenance hemodialysis patients

et al. 2021

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Microwave ablation has been increasingly used to secondary hyperparathyroidism (SHPT) in patients with maintenance hemodialysis. However, the current data are inconclusive. This study was to assess the long-term outcomes of microwave ablation on SHPT. We enrolled 53 SHPT patients who underwent microwave ablation. Primary outcome measures were the rate of achieving recommended goal for iPTH and the events of all-cause death during the followup period. Survival analysis was performed to assess the long-term prognosis. During follow-up period of 42.4 ± 15.6 months (range, 12-70 months), there were 12 all-cause deaths, and the cumulative proportion surviving was 0.74. The rates of achieving the recommended goal for iPTH were 62.3% at 1 month, 57.7% at 6 months, 51.0% at 12 months, 62.5% at 24 months, and 68.8% at 36 months, respectively. Microwave ablation produces a lasting resolution of

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Evocalcet: A New Oral Calcimimetic for Dialysis Patients With Secondary Hyperparathyroidism

Cited by 25 publications

References 48 publications

Efficacy of Evocalcet in Previously Cinacalcet-Treated Secondary Hyperparathyroidism Patients

Efficacy of Evocalcet in Previously Cinacalcet-Treated Secondary Hyperparathyroidism Patients

Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease

Long‐term outcomes of microwave ablation for secondary hyperparathyroidism in maintenance hemodialysis patients

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