Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

Kentaro Nakai; Keiji Kono; Shunsuke Yamada; Masatomo Taniguchi; Takayuki Hamano; Masafumi Fukagawa

doi:10.1111/1744-9987.14125

Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies

Ther Apher Dial. 2024 Mar 18. doi: 10.1111/1744-9987.14125. Online ahead of print.

Authors

Kentaro Nakai¹, Keiji Kono², Shunsuke Yamada³, Masatomo Taniguchi⁴, Takayuki Hamano⁵, Masafumi Fukagawa⁶

Affiliations

¹ Division of Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
² Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Fukuoka Renal Clinic, Fukuoka, Japan.
⁵ Department of Nephrology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
⁶ Division of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan.

PMID: 38499495
DOI: 10.1111/1744-9987.14125

Abstract

Introduction: Several calcimimetics, other than cinacalcet, are commercially available; however, their effects on calcium and phosphate levels have not yet been fully studied. We conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the impact of calcimimetics on the management of serum calcium and phosphate levels in patients with secondary hyperparathyroidism undergoing dialysis.

Methods: A systematic literature search through October 2023 and a meta-analysis were conducted on the effects of upacicalcet, etelcalcetide, evocalcet, and cinacalcet on serum calcium and phosphate levels in patients with secondary hyperparathyroidism undergoing dialysis; we searched PubMed, Ovid MEDLINE, and the Cochrane Central Register of Controlled Trials, and 21 studies comprising 6371 patients undergoing dialysis were included.

Results: Participants treated with calcimimetics had lower serum calcium and phosphate levels than placebo.

Conclusion: Calcimimetics significantly reduced serum calcium and phosphate levels compared to placebo in patients with secondary hyperparathyroidism undergoing dialysis, independent of therapeutic strategy or concomitant vitamin D treatment.

Keywords: calcimimetics; dialysis; hyperparathyroidism; parathyroid hormone; vitamin D.