Abstract: SA-PO671
Conversion from Cinacalcet to Etelcalcetide in a Mid-Size Dialysis Organization: Real-World Therapeutic Conversion
Session Information
- Bone and Mineral Metabolism: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Shang, Dongyang, Satellite Healthcare, San Jose, California, United States
- Collard, Shaun S., Satellite Healthcare, San Jose, California, United States
- Abra, Graham E., Satellite Healthcare, San Jose, California, United States
- Schiller, Brigitte, Satellite Healthcare, San Jose, California, United States
Background
There are two FDA approved calcimimetics available in the United States, intravenous etelcalcetide and oral cinacalcet. There is limited data to guide therapeutic conversion from cinacalcet to etelcalcetide in a real-world hemodialysis (HD) setting. Here we describe our experience with conversion from cinacalcet to etelcalcetide HD patients in a mid-size dialysis provider organization.
Methods
Data from 1264 in-center hemodialysis patients treated with cinacalcet from 60 dialysis centers from December 2017 to April 2018 are reported. Conversion from cinacalcet to etelcalcetide occurred in February 2018. All patients started etelcalcetide at 2.5 mg IV three times a week regardless of previous cinacalcet dose after a 7 day wash out period. Etelcalcetide doses were subsequently adjusted monthly to achieve a target iPTH of 150-700 pg/mL and an adjusted calcium of 8.0-10.2 mg/dL.
Results
The percentage of patients with an adjusted calcium reaching the target iPTH declined temporarily, but increased in month 1 and 2 after conversion. Monitoring in all patients treated with etelcalcetide, recorded the following adverse events (AEs) profiles: 4% of patients experienced nausea/vomiting and 24% hypotension. No severe AEs were reported.
Conclusion
In this real-world dosing conversion from cinacalcet to etelcalcetide aggregated biochemical targets after converting all patients to etelcalcetide 2.5 mg IV three times a week regardless of previous cinacalcet dose showed a decrease in percentage of patients reaching iPTH targets during conversion month with improving iPTH results in the subsequent two months post conversion. Side effect profile was unchanged compared to commonly reported AEs.
Figure: Proportion of Converted Patients by iPTH Ranges