The effects of switching from etelcalcetide to upacicalcet in hemodialysis patients with secondary hyperparathyroidism.

AIMS: No English-language research papers have reported on the clinical use of upacicalcet, a novel intravenous calcimimetic agent for the treatment of secondary hyperparathyroidism (SHPT) in hemodialysis patients. Therefore, this study aimed to investigate the outcomes of switching from etelcalcetide to upacicalcet.

MATERIALS AND

METHODS

The subjects included 37 hemodialysis patients with SHPT treated with etelcalcetide before switching to upacicalcet. This study was a single-center retrospective study conducted in Japan. Serum levels of corrected calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), and the dose of maxacalcitol were assessed at 3 and 6 months after switching to upacicalcet.

RESULTS

As a result of the switch from etelcalcetide to upacicalcet, the serum corrected Ca level remained unchanged, from 8.9 ± 0.6 to 9.1 ± 0.7 mg/dL (p = 0.104) at 3 months and to 9.0 ± 0.6 mg/dL (p = 0.197) at 6 months. Meanwhile, the serum P level decreased from 6.3 ± 1.5 to 5.8 ± 1.5 mg/dL (p = 0.069) at 3 months and to 5.9 ± 1.9 mg/dL (p = 0.039) at 6 months. The iPTH level increased slightly, from 153.8 ± 100.3 pg/mL to 176.4 ± 124.6 pg/mL (p = 0.337) at 3 months and to 206.5 ± 168.7 pg/mL (p = 0.017) at 6 months. Multiple regression analysis revealed that the change in iPTH was related to the change in P levels.

CONCLUSION

These findings suggested that upacicalcet may be a useful option for managing serum P levels in hemodialysis patients with SHPT.