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Influence on quality of life from an early cinacalcet prescription for secondary hyperparathyroidism in dialysis

Abstract : The goal of this study is to compare patient-reported quality of life (PRQOL) evolution between two groups of end-stage renal disease patients with secondary hyperparathyroidism (SHPT). The first with a cinacalcet prescription within 3months after a diagnosis of SHPT (early group) and a second group of patients with a later or no cinacalcet prescription (nonearly group). Patients and methodsFrom 2009 to 2012, we conducted a multicenter pharmaco-epidemiologic study in Lorraine region (France) including all consecutive patients on maintenance dialysis for at least 3months with a diagnosis of SHPT (PTH>500pg/ml or first cinacalcet prescription). PRQOL was estimated using the Kidney Disease Quality Of Life-Short Form questionnaire, at baseline and at 6 and 12months follow-up. Change in PRQOL was compared between the groups and adjusted with a propensity score. ResultsWe included 124 patients: 44 in the early group and 80 in the nonearly group. The mental component summary score was lower in the early group, at baseline (43.66.6 vs 46.6 +/- 7.6; p=0.030), and at the follow-up assessment (42.6 +/- 6.9 vs 45.7 +/- 7.9; p=0.033). We found no difference between the groups in change in PRQOL, for all dimensions, even after adjustment with the propensity score. Mean serum alkaline phosphatase levels were normal in both groups at baseline (80.9 +/- 32.5 vs 95.1 +/- 39.6; p=0.41). ConclusionCinacalcet prescription immediately following diagnosis of SHPT does not seem to be associated with better PRQOL evolution at 1year. Mean serum alkaline phosphatase levels suggest that physicians should consider waiting for another PTH assay result before starting cinacalcet in case of a PTH rise.
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Submitted on : Wednesday, January 10, 2018 - 2:33:26 PM
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Pierre Filipozzi, Carole Ayav, Marie-Line Erpelding, Michele Kessler, Laurent Brunaud, et al.. Influence on quality of life from an early cinacalcet prescription for secondary hyperparathyroidism in dialysis. Pharmacoepidemiology and Drug Safety, 2015, 24 (2), pp.187 - 196. ⟨10.1002/pds.3683⟩. ⟨hal-01680224⟩



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