Kidney Week

Abstract: SA-PO668

Etelcalcetide Utilization Pattern in a Mid-Size Dialysis Organization

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

• Arnott, Virginia (Ginger) S., U.S. Renal Care, Midlothian, Texas, United States

Virginia (Ginger) S. Arnott,

• Lin, Tzu-Chieh, Amgen, THOUSAND OAKS, California, United States

Tzu-Chieh Lin,

• Hallett, David C., Amgen Inc., Glendale, California, United States

David C. Hallett,

• Bhatt, Nisha, Amgen, THOUSAND OAKS, California, United States

Nisha Bhatt,

• Erinle, Ayodele, High Desert Nephrology Associates, Gallup, New Mexico, United States

Ayodele Erinle,

Background

Etelcalcetide is a new calcimimetic agent just entered into clinical practice. The aims of this study are to describe the initial etelcalcetide doses, titration and changes of three key laboratory indices for secondary hyperparathyroidism (SHPT) management.

Methods

This retrospective cohort study included all US ESRD patients ≥18 years, who had received in-center hemodialysis at US Renal Care centers and initiated etelcalcetide between 2/2017 and 2/2018. Every patient was followed from etelcalcetide initiation date until the earliest date of 6 months, death, transplantation, parathyroidectomy, termination of follow-up. Descriptive analyses (mean, median and %) for etelcalcetide dosage, 3 key laboratory indices for SHPT management (parathyroid hormone (PTH), corrected calcium (cCa) and phosphorus (P)) were presented at baseline period and during follow-up.

Results

A total of 1,100 patients initiated etelcalcetide, and the mean (SD) age was 58.7±13.8 years. A total of 86.4% of patients initiated etelcalcetide at 5mg, and 11.4% at 2.5mg three times a week (TIW). The mean (SD) monthly dosage increased from 5.0±1.3 mg at the first month to 6.9±3.6 mg at the 6^th month (Figure 1A). After etelcalcetide initiation, the proportion of patients achieved a PTH goal of <600 increased from 19% to 51%. During follow-up, 19-24% of patients had at least one cCa level <8.4mg/dL, with <2% (of 1,100) had cCa <7.5 mg/dL (Figure 1B). The median P level remained between 5.5-5.7 mg/dL during follow-up.

Conclusion

We found the vast majority of patients were initiated on etelcalcetide at a dose of 5 mg TIW consistent with approved prescribing information. The prevalence of serious hypocalcemia was low, with less than 2% of patients ever having cCa levels <7.5 mg/dL.

Funding

• Commercial Support – Amgen, Thousand Oaks