Skip to main content

27.03.2024 | Original Article

Effectiveness of calcimimetics on fractures in dialysis patients with secondary hyperparathyroidism: meta-analysis of randomized trials

verfasst von: Takuya Wakamatsu, Suguru Yamamoto, Koji Matsuo, Masatomo Taniguchi, Takayuki Hamano, Masafumi Fukagawa, Junichiro James Kazama

Erschienen in: Journal of Bone and Mineral Metabolism

Einloggen, um Zugang zu erhalten

Abstract

Introduction

This study aimed to assess the effectiveness of calcimimetics in reducing the risk of fractures in dialysis patients with secondary hyperparathyroidism (SHPT).

Material and methods

A comprehensive literature search was conducted using PubMed, Embase, and Cochrane Library for articles published through December 9, 2023. The quality of each trial was evaluated using the Cochrane Collaboration tool. Meta-analysis was performed using a random-effects model, and effect measures across studies were synthesized. The risk ratio (RR) and 95% confidence interval (CI) were used to quantify the risk of fracture.

Results

We identified seven studies involving 6481 dialysis patients with SHPT. The administration of calcimimetics reduced fracture incidence compared to placebo or conventional treatment (RR: 0.50, 95% CI 0.29–0.88, p = 0.02). Calcimimetics demonstrated a low number needed to treat (NNT) to prevent an incident fracture (NNT: 47).

Conclusion

The use of calcimimetics offers a significant benefit in reducing the risk of fractures in patients undergoing dialysis with SHPT.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
5.
Zurück zum Zitat Tentori F, Wang M, Bieber BA, Karaboyas A, Li Y, Jacobson SH, Andreucci VE, Fukagawa M, Frimat L, Mendelssohn DC, Port FK, Pisoni RL, Robinson BM (2015) Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Clin J Am Soc Nephrol: CJASN 10:98–109. https://doi.org/10.2215/CJN.12941213CrossRefPubMed Tentori F, Wang M, Bieber BA, Karaboyas A, Li Y, Jacobson SH, Andreucci VE, Fukagawa M, Frimat L, Mendelssohn DC, Port FK, Pisoni RL, Robinson BM (2015) Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Clin J Am Soc Nephrol: CJASN 10:98–109. https://​doi.​org/​10.​2215/​CJN.​12941213CrossRefPubMed
6.
Zurück zum Zitat Taniguchi M, Fukagawa M, Fujii N, Hamano T, Shoji T, Yokoyama K, Nakai S, Shigematsu T, Iseki K, Tsubakihara Y, Committee of Renal Data Registry of the Japanese Society for Dialysis T (2013) Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Ther Apher Dial: Off Peer-Rev J Int Soc Apher Jpn Soc Apher Jan Soc Dial Ther 17:228. https://doi.org/10.1111/1744-9987.12030CrossRef Taniguchi M, Fukagawa M, Fujii N, Hamano T, Shoji T, Yokoyama K, Nakai S, Shigematsu T, Iseki K, Tsubakihara Y, Committee of Renal Data Registry of the Japanese Society for Dialysis T (2013) Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Ther Apher Dial: Off Peer-Rev J Int Soc Apher Jpn Soc Apher Jan Soc Dial Ther 17:228. https://​doi.​org/​10.​1111/​1744-9987.​12030CrossRef
8.
Zurück zum Zitat Fernandez-Martin JL, Martinez-Camblor P, Dionisi MP, Floege J, Ketteler M, London G, Locatelli F, Gorriz JL, Rutkowski B, Ferreira A, Bos WJ, Covic A, Rodriguez-Garcia M, Sanchez JE, Rodriguez-Puyol D, Cannata-Andia JB, group C, (2015) Improvement of mineral and bone metabolism markers is associated with better survival in haemodialysis patients: the COSMOS study. Nephrol, Dial, Transplant : Off Publ Eur Dial Transplant Assoc - Eur Ren Assoc 30:1542–1551. https://doi.org/10.1093/ndt/gfv099CrossRef Fernandez-Martin JL, Martinez-Camblor P, Dionisi MP, Floege J, Ketteler M, London G, Locatelli F, Gorriz JL, Rutkowski B, Ferreira A, Bos WJ, Covic A, Rodriguez-Garcia M, Sanchez JE, Rodriguez-Puyol D, Cannata-Andia JB, group C, (2015) Improvement of mineral and bone metabolism markers is associated with better survival in haemodialysis patients: the COSMOS study. Nephrol, Dial, Transplant : Off Publ Eur Dial Transplant Assoc - Eur Ren Assoc 30:1542–1551. https://​doi.​org/​10.​1093/​ndt/​gfv099CrossRef
9.
Zurück zum Zitat Wakasugi M, Kazama JJ, Kikuchi K, Yasuda K, Wada A, Hamano T, Masakane I, Narita I (2019) Hemodialysis product and hip fracture in hemodialysis patients: a nationwide cohort study in Japan. Ther Apher Dial: Off Peer-Rev J Int Soc Apher, Jpn Soc Apher, Jpn Society Dial Ther 23:507–517. https://doi.org/10.1111/1744-9987.12807CrossRef Wakasugi M, Kazama JJ, Kikuchi K, Yasuda K, Wada A, Hamano T, Masakane I, Narita I (2019) Hemodialysis product and hip fracture in hemodialysis patients: a nationwide cohort study in Japan. Ther Apher Dial: Off Peer-Rev J Int Soc Apher, Jpn Soc Apher, Jpn Society Dial Ther 23:507–517. https://​doi.​org/​10.​1111/​1744-9987.​12807CrossRef
10.
11.
Zurück zum Zitat Custodio MR, Koike MK, Neves KR, dos Reis LM, Graciolli FG, Neves CL, Batista DG, Magalhaes AO, Hawlitschek P, Oliveira IB, Dominguez WV, Moyses RM, Jorgetti V (2012) Parathyroid hormone and phosphorus overload in uremia: impact on cardiovascular system. Nephrol, Dial, Transplant: Off Publ Eur Dial Transplant Assoc – Eur Ren Assoc 27:1437–1445. https://doi.org/10.1093/ndt/gfr447CrossRef Custodio MR, Koike MK, Neves KR, dos Reis LM, Graciolli FG, Neves CL, Batista DG, Magalhaes AO, Hawlitschek P, Oliveira IB, Dominguez WV, Moyses RM, Jorgetti V (2012) Parathyroid hormone and phosphorus overload in uremia: impact on cardiovascular system. Nephrol, Dial, Transplant: Off Publ Eur Dial Transplant Assoc – Eur Ren Assoc 27:1437–1445. https://​doi.​org/​10.​1093/​ndt/​gfr447CrossRef
13.
Zurück zum Zitat Investigators ET, Chertow GM, Block GA, Correa-Rotter R, Drueke TB, Floege J, Goodman WG, Herzog CA, Kubo Y, London GM, Mahaffey KW, Mix TC, Moe SM, Trotman ML, Wheeler DC, Parfrey PS (2012) Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med 367:2482–2494. https://doi.org/10.1056/NEJMoa1205624CrossRef Investigators ET, Chertow GM, Block GA, Correa-Rotter R, Drueke TB, Floege J, Goodman WG, Herzog CA, Kubo Y, London GM, Mahaffey KW, Mix TC, Moe SM, Trotman ML, Wheeler DC, Parfrey PS (2012) Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med 367:2482–2494. https://​doi.​org/​10.​1056/​NEJMoa1205624CrossRef
16.
Zurück zum Zitat Block GA, Bushinsky DA, Cheng S, Cunningham J, Dehmel B, Drueke TB, Ketteler M, Kewalramani R, Martin KJ, Moe SM, Patel UD, Silver J, Sun Y, Wang H, Chertow GM (2017) Effect of etelcalcetide vs cinacalcet on serum parathyroid hormone in patients receiving hemodialysis with secondary hyperparathyroidism: a randomized clinical trial. JAMA 317:156–164. https://doi.org/10.1001/jama.2016.19468CrossRefPubMed Block GA, Bushinsky DA, Cheng S, Cunningham J, Dehmel B, Drueke TB, Ketteler M, Kewalramani R, Martin KJ, Moe SM, Patel UD, Silver J, Sun Y, Wang H, Chertow GM (2017) Effect of etelcalcetide vs cinacalcet on serum parathyroid hormone in patients receiving hemodialysis with secondary hyperparathyroidism: a randomized clinical trial. JAMA 317:156–164. https://​doi.​org/​10.​1001/​jama.​2016.​19468CrossRefPubMed
18.
Zurück zum Zitat Moe SM, Abdalla S, Chertow GM, Parfrey PS, Block GA, Correa-Rotter R, Floege J, Herzog CA, London GM, Mahaffey KW, Wheeler DC, Dehmel B, Goodman WG, Drueke TB, Evaluation of Cinacalcet HTtLCETI (2015) Effects of cinacalcet on fracture events in patients receiving hemodialysis: the evolve trial. J Am Soc Nephrol 26:1466–1475. https://doi.org/10.1681/ASN.2014040414CrossRefPubMed Moe SM, Abdalla S, Chertow GM, Parfrey PS, Block GA, Correa-Rotter R, Floege J, Herzog CA, London GM, Mahaffey KW, Wheeler DC, Dehmel B, Goodman WG, Drueke TB, Evaluation of Cinacalcet HTtLCETI (2015) Effects of cinacalcet on fracture events in patients receiving hemodialysis: the evolve trial. J Am Soc Nephrol 26:1466–1475. https://​doi.​org/​10.​1681/​ASN.​2014040414CrossRefPubMed
26.
Zurück zum Zitat Komaba H, Zhao J, Karaboyas A, Yamamoto S, Dasgupta I, Hassan M, Zuo L, Christensson A, Combe C, Robinson BM, Fukagawa M (2023) Active vitamin D use and fractures in hemodialysis patients: results from the international DOPPS. J Bone Miner Res: Off J Am Soc Bone Miner Res 38:1577–1585. https://doi.org/10.1002/jbmr.4913CrossRef Komaba H, Zhao J, Karaboyas A, Yamamoto S, Dasgupta I, Hassan M, Zuo L, Christensson A, Combe C, Robinson BM, Fukagawa M (2023) Active vitamin D use and fractures in hemodialysis patients: results from the international DOPPS. J Bone Miner Res: Off J Am Soc Bone Miner Res 38:1577–1585. https://​doi.​org/​10.​1002/​jbmr.​4913CrossRef
30.
31.
Zurück zum Zitat Li X, Yu L, Asuncion F, Grisanti M, Alexander S, Hensley K, Han CY, Niu QT, Dwyer D, Villasenor K, Stolina M, Dean C Jr, Ominsky MS, Ke HZ, Tomlinson JE, Richards WG (2017) Etelcalcetide (AMG 416), a peptide agonist of the calcium-sensing receptor, preserved cortical bone structure and bone strength in subtotal nephrectomized rats with established secondary hyperparathyroidism. Bone 105:163–172. https://doi.org/10.1016/j.bone.2017.08.026CrossRefPubMed Li X, Yu L, Asuncion F, Grisanti M, Alexander S, Hensley K, Han CY, Niu QT, Dwyer D, Villasenor K, Stolina M, Dean C Jr, Ominsky MS, Ke HZ, Tomlinson JE, Richards WG (2017) Etelcalcetide (AMG 416), a peptide agonist of the calcium-sensing receptor, preserved cortical bone structure and bone strength in subtotal nephrectomized rats with established secondary hyperparathyroidism. Bone 105:163–172. https://​doi.​org/​10.​1016/​j.​bone.​2017.​08.​026CrossRefPubMed
34.
Zurück zum Zitat Fukagawa M, Yokoyama K, Koiwa F, Taniguchi M, Shoji T et al (2013) Clinical practice guideline for the management of chronic kidney disease-mineral and bone disorder (in eng). Ther Apher And Dial: Off Peer-Rev J Int Soc Apher, Jpn Soc Apher, Jpn Soc Dial Ther 17:247–288. https://doi.org/10.1111/1744-9987.12058CrossRef Fukagawa M, Yokoyama K, Koiwa F, Taniguchi M, Shoji T et al (2013) Clinical practice guideline for the management of chronic kidney disease-mineral and bone disorder (in eng). Ther Apher And Dial: Off Peer-Rev J Int Soc Apher, Jpn Soc Apher, Jpn Soc Dial Ther 17:247–288. https://​doi.​org/​10.​1111/​1744-9987.​12058CrossRef
Metadaten
Titel
Effectiveness of calcimimetics on fractures in dialysis patients with secondary hyperparathyroidism: meta-analysis of randomized trials
verfasst von
Takuya Wakamatsu
Suguru Yamamoto
Koji Matsuo
Masatomo Taniguchi
Takayuki Hamano
Masafumi Fukagawa
Junichiro James Kazama
Publikationsdatum
27.03.2024
Verlag
Springer Nature Singapore
Erschienen in
Journal of Bone and Mineral Metabolism
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-024-01500-y

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

CAR-M-Zellen: Warten auf das große Fressen

22.05.2024 Onkologische Immuntherapie Nachrichten

Auch myeloide Immunzellen lassen sich mit chimären Antigenrezeptoren gegen Tumoren ausstatten. Solche CAR-Fresszell-Therapien werden jetzt für solide Tumoren entwickelt. Künftig soll dieser Prozess nicht mehr ex vivo, sondern per mRNA im Körper der Betroffenen erfolgen.

Frühzeitige HbA1c-Kontrolle macht sich lebenslang bemerkbar

22.05.2024 Typ-2-Diabetes Nachrichten

Menschen mit Typ-2-Diabetes von Anfang an intensiv BZ-senkend zu behandeln, wirkt sich positiv auf Komplikationen und Mortalität aus – und das offenbar lebenslang, wie eine weitere Nachfolgeuntersuchung der UKPD-Studie nahelegt.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.