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Cochrane Database of Systematic Reviews

Calcimimetics for secondary hyperparathyroidism in chronic kidney disease patients

Overview of attention for article published in Cochrane database of systematic reviews, October 2006
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Title
Calcimimetics for secondary hyperparathyroidism in chronic kidney disease patients
Published in
Cochrane database of systematic reviews, October 2006
DOI 10.1002/14651858.cd006254
Pubmed ID
Authors

Strippoli, Giovanni FM, Tong, Allison, Palmer, Suetonia C, Elder, Grahame J, Craig, Jonathan C, Strippoli, G F M, Tong, A, Palmer, S C, Elder, G, Craig, J C

Abstract

Calcimimetic agents have recently been evaluated in the treatment of secondary hyperparathyroidism (SHPT) as add-on therapy to calcitriol and vitamin D analogues and dietary phosphate binders. To evaluate the benefits and harms of calcimimetics for the prevention of secondary hyperparathyroid bone disease (including osteitis fibrosa cystica and adynamic bone disease) in dialysis patients with chronic kidney disease (CKD). MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and conference proceedings were searched for randomised controlled trials (RCTs) evaluating any calcimimetic against placebo or another agent in pre-dialysis or dialysis patients with CKD. We included all RCTs of any calcimimetic agent, cinacalcet HCl (AMG-073, Sensipar), NPS R-467 or NPS R-568 administered to patients with CKD for the treatment of SHPT. Data were extracted on all relevant patient-centred and surrogate outcomes. Analysis was by a random effects model and results expressed as relative risk (RR) or weighted mean difference (MD) with 95% confidence intervals. Eight studies (1429 patients) were identified, which compared a calcimimetic agent plus standard therapy to placebo plus standard therapy. The end of treatment values of parathyroid hormone (pg/mL) (MD -290.79, 95% CI -360.23 to -221.34), serum calcium (mg/dL) (MD -0.85, 95% CI -1.14 to -0.56), serum phosphorus (mg/dL) (MD -0.29, 95% CI -0.50 to -0.08) and the calcium by phosphorus product (mg(2)/dL(2))(MD -7.90, 95% CI -10.25 to -5.54) were significantly lower with calcimimetics compared to placebo. No significant effects on patient-based endpoints were demonstrated except for the risk of hypotension which was significantly reduced with calcimimetics compared to placebo (RR 0.53, 95%CI 0.36 to 0.79). Calcimimetic treatment of SHPT leads to significant improvements in biochemical parameters that observational studies have shown to be associated with increased mortality, cardiovascular risk and osteitis fibrosa, but patient-based benefits have not yet been demonstrated in trials. For patients with SHPT, the benefits of calcimimetics over standard therapy remain uncertain until further RCTs become available.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 2%
Unknown 45 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 20%
Other 6 13%
Student > Bachelor 6 13%
Researcher 6 13%
Student > Doctoral Student 3 7%
Other 11 24%
Unknown 5 11%
Readers by discipline Count As %
Medicine and Dentistry 28 61%
Nursing and Health Professions 4 9%
Linguistics 2 4%
Agricultural and Biological Sciences 2 4%
Psychology 2 4%
Other 3 7%
Unknown 5 11%