Cinacalcet (Sensipar) Provides no Measurable Clinical Benefits for Patients with Primary Hyperparathyroidism and may Accelerate Bone Loss with Prolonged Use.

Summary of "Cinacalcet (Sensipar) Provides no Measurable Clinical Benefits for Patients with Primary Hyperparathyroidism and may Accelerate Bone Loss with Prolonged Use."

Cinacalcet (Sensipar) has been shown to decrease calcium levels in patients with primary hyperparathyroidism (PHPT); however, few other endpoints have been studied and long-term effects are not known.
At the discretion of a referring doctor, 70 patients began Cinacalcet as an alternative to surgery for PHPT. Patients were followed as long as the drug was tolerated at which time all underwent parathyroidectomy.
Before treatment, serum calcium levels averaged 11.7 ± 0.5 (range, 11.0-15.1) and PTH averaged 156 ± 42 (range, 88-815); 93% had two or more classic parathyroid symptoms (average, 5.3; range, 0-9). Cinacalcet was discontinued in 19 patients (26%) within 4 months because of nausea/vomiting. The remainder (n = 51) were treated from 8 to 28 months. Calcium levels decreased in all patients but remained variable. PTH levels decreased in 80% of patients but always remained elevated. Only 3 (6%) had symptom relief (p = 0.8), whereas 11 (21.6%) felt worse (p < 0.05). Twenty-three patients took Cinacalcet for >1.5 years, 14 of which showed significant (>1 SD) decreases in bone density (p < 0.05), and none had increases in bone density. All had curative outpatient parathyroid surgery followed by partial or complete resolution of symptoms within 3 months in 88% (p < 0.001).
Cinacalcet reduces serum calcium but is not tolerated by many patients. Cinacalcet does not provide symptom relief of PHPT and more commonly increases subjective symptoms. Prolonged use is associated with continued bone loss in some patients, possibly due to persistent elevated PTH levels. With very few exceptions, pHPT can be cured via a quick outpatient operation, which remains the treatment of choice.


Norman Parathyroid Center, Tampa, FL, USA,

Journal Details

This article was published in the following journal.

Name: Annals of surgical oncology
ISSN: 1534-4681


DeepDyve research library

PubMed Articles [45914 Associated PubMed Articles listed on BioPortfolio]

Intraoperative and postoperative hyperkalaemia after total parathyroidectomy following exposure to cinacalcet in sixteen patients for renal hyperparathyroidism.

Our clinical observation suggested that patients with prior treatment with cinacalcet and undergoing parathyroidectomy for renal hyperparathyroidism had greater acute hyperkalaemia in the intraoperati...

Etelcalcetide for the treatment of secondary hyperparathyroidism.

Calcium sensing receptor is an important target for the treatment of secondary hyperparathyroidism (SHPT). Etelcalcetide hydrochloride is a novel peptide calcimimetic agent that has a similar mechanis...

Cinacalcet in peritoneal dialysis patients: one-center experience.

Secondary hyperparathyroidism is the target of several therapeutic strategies, including the use of cinacalcet. Most studies were done only in hemodialysis patients, with few data from peritoneal dial...

Effect of parathyroidectomy and cinacalcet on quality of life in patients with end-stage renal disease-related hyperparathyroidism: a systematic review.

Patients with end-stage renal disease (ESRD) have a decreased quality of life (QoL), which is attributable in part to ESRD-related hyperparathyroidism (HPT). Both cinacalcet and parathyroidectomy (PTx...

The Translational Science Benefits Model: A New Framework for Assessing the Health and Societal Benefits of Clinical and Translational Sciences.

We report the development of the Translational Science Benefits Model (TSBM), a framework designed to support institutional assessment of clinical and translational research outcomes to measure clinic...

Clinical Trials [3628 Associated Clinical Trials listed on BioPortfolio]

E.V.O.L.V.E. Trial™: EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events

The purpose of this study is to evaluate the effects of cinacalcet (cinacalcet HCl or Sensipar®/Mimpara®) on cardiovascular events and death in chronic kidney disease (CKD) patients with...

Effect of Cinacalcet on Parathyroid Hormone Secretion in Children and Adolescents With Hypophosphatemic Rickets

This study will measure the effect of cinacalcet (Sensipar) on parathyroid hormone (PTH) secretion in children and adolescents with hypophosphatemic rickets (XLH). The investigators are s...

Bone Biopsy Study For Dialysis Patients With Secondary Hyperparathyroidism of End Stage Renal Disease

The purpose of this study is to evaluate the effects of cinacalcet on bone function and bone cells in patients with kidney disease who are receiving dialysis.

PRIMARA: A Prospective Descriptive Observational Study to Review Mimpara (Cinacalcet) Use in Patients With Primary Hyperparathyroidism in Clinical Practice

This is a multicentre, descriptive observational study of adult patients with primary HPT receiving cinacalcet in clinical practice in a number of countries in Europe (including Russia). ...

Efficacy and Safety of Cinacalcet in Ca, P and iPTH Levels in Patients With Mild, Moderate and Severe SHPT

1. To evaluate achievement ratio of iPTH,Calcium and phosphorus after taking Cinacalcet HCL in hemodialysis subjects with mild, moderate and severe SHPT; 2. To explore the impact o...

Medical and Biotech [MESH] Definitions

A 1974 Federal act which preempts states' rights with regard to workers' pension benefits and employee benefits. It does not affect the benefits and rights of employees whose employer is self-insured. (From Slee & Slee, Health Care Reform Terms, 1993)

The remuneration paid or benefits granted to an employee.

Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits.

Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed.

A selective beta-1-adrenergic partial agonist. Because it is a partial agonist (DRUG PARTIAL AGONISM) it acts like an agonist when sympathetic activity is low and as an antagonist when sympathetic activity is high. It reduces MYOCARDIAL ISCHEMIA and improves ventricular function in patients with mild to moderate heart failure. In patients with severe heart failure it has been shown to produce benefits in systolic and diastolic function.

Quick Search

DeepDyve research library

Relevant Topics

Osteoporosis is a disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse. Follow and track&n...

Within medicine, nutrition (the study of food and the effect of its components on the body) has many different roles. Appropriate nutrition can help prevent certain diseases, or treat others. In critically ill patients, artificial feeding by tubes need t...

Searches Linking to this Article