Date: Tuesday, May 5, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 3:15pm-3:27pm
Location: Room 119-B
- Prospective and Randomized Trial Comparing Tacrolimus Versus Sirolimus after Simultaneous Pancreas-Kidney Transplantation
- Long-Term Results After Heart Transplantation A Randomized Trial Comparing Tacrolimus Versus Cyclosporine A in Combination With Mycophenolate Mofetil After a Mean Duration of 15 Years
Purpose: Cinacalcet corrects hypercalcemia and hypophosphatemia in patients with persistent hyperparathyroidism (HPT) after kidney transplantation (KT). This study (NCT011178450) was designed to evaluate whether subtotal parathyroidectomy (PTX, standard of care) was superior to cinacalcet (CIN) to control HPT after KT.
Methods: This is a 12-M, prospective, multicenter, randomized study. Kidney allograft recipients were included if time after transplantation is > 6 m, eGFR > 30 ml/min, iPTH> 15 pmol/L, serum calcium (sCa) > 2.63 mmol/L, serum phosphate (sP) <1.2 mmol/L. The primary end point was achievement of normocalcemia. Secondary end points were iPTH, sP, eGFR, bone mineral density and vascular calcification.
Results: A total of 30 patients were randomized (PTX, N=15; CIN, N=15). Baseline characteristics were similar between groups, including serum calcidiol level (44±26 in CIN vs 41±15 in PTX) and eGFR (57±11 in CIN, 56±15 in PTX). By ITT analysis both treatments were able to correct hypercalcemia although only PTX induced iPTH and sP normalization.
|CIN, N=15||PTX, N=15||P value|
|iPTH 12 m||22±11||6±5||0.001|
Moreover, PTX was associated with better preservation of renal function (12-M δ eGFR was -9 ml/min in CIN vs -4 ml/min in PTX). Safety data was similar between groups.
Conclusion: Subtotal parathyroidectomy was superior to cinacalcet to control HPT after KT
To cite this abstract in AMA style:Cruzado J, Torregrosa V, Mast R, García-Barrasa A, Bestard O, Melilli E, Francos J, Torras J, Polo C, Gómez-Vaquero C, Grinyó J, Moreno P. A Randomized Study Comparing Parathyroidectomy Versus Cinacalcet to Treat Hypercalcemia in Kidney Allograft Recipients With Persistent Hyperparathyroidism [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/a-randomized-study-comparing-parathyroidectomy-versus-cinacalcet-to-treat-hypercalcemia-in-kidney-allograft-recipients-with-persistent-hyperparathyroidism/. Accessed July 4, 2020.
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