Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation
Introduction: secondary hyperparathyroidism (SHP) is frequent in patients with chronic kidney disease (CKD), particularly in those in dialysis. To treat this complication, the current options available include phosphorus restriction, phosphate binders, the inhibition of parathyroid hormone (PTH) syn...
- Autores:
-
D’Marco, Luis
Checa-Ros, Ana
Gamero, Dionilux
Soto, Carlos
Salazar, Juan
Nava, Manuel
Bermúdez, Valmore
Dapana, Fabiola
- Tipo de recurso:
- Fecha de publicación:
- 2022
- Institución:
- Universidad Simón Bolívar
- Repositorio:
- Repositorio Digital USB
- Idioma:
- eng
- OAI Identifier:
- oai:bonga.unisimon.edu.co:20.500.12442/13230
- Acceso en línea:
- https://hdl.handle.net/20.500.12442/13230
https://doi.org/10.3390/healthcare11010072
- Palabra clave:
- calcimimetics; vitamin D analogs; chronic kidney disease; inflammation
- Rights
- openAccess
- License
- Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| title |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| spellingShingle |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation calcimimetics; vitamin D analogs; chronic kidney disease; inflammation |
| title_short |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| title_full |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| title_fullStr |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| title_full_unstemmed |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| title_sort |
Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation |
| dc.creator.fl_str_mv |
D’Marco, Luis Checa-Ros, Ana Gamero, Dionilux Soto, Carlos Salazar, Juan Nava, Manuel Bermúdez, Valmore Dapana, Fabiola |
| dc.contributor.author.none.fl_str_mv |
D’Marco, Luis Checa-Ros, Ana Gamero, Dionilux Soto, Carlos Salazar, Juan Nava, Manuel Bermúdez, Valmore Dapana, Fabiola |
| dc.subject.spa.fl_str_mv |
calcimimetics; vitamin D analogs; chronic kidney disease; inflammation |
| topic |
calcimimetics; vitamin D analogs; chronic kidney disease; inflammation |
| description |
Introduction: secondary hyperparathyroidism (SHP) is frequent in patients with chronic kidney disease (CKD), particularly in those in dialysis. To treat this complication, the current options available include phosphorus restriction, phosphate binders, the inhibition of parathyroid hormone (PTH) synthesis and secretion by the supplementation of vitamin D or VDR activators, or the use of calcimimetics. Beyond the control of PTH, the effects of the treatment of SHP on other biomarkers of risk may represent an additional benefit for this population. In this study, we explore the benefits of current SHP treatment options, mainly paricalcitol and/or etelcalcetide in the inflammatory state of hemodialysis (HD) patients. Results: the study finally included 142 maintenance HD patients (5 patients were excluded) followed for 6 months (dialysis vintage 26 30 months, mean age 70 years old, 73% women, 81% Spanish white, 47% diabetic). In this case, 52 patients were on regular treatment with paricalcitol for SHP and 25 patients were eligible to initiate etelcalcetide. The baseline serum levels of Ca, P, PTH, Ferritin, albumin, C-reactive protein (CRP), and other variables were measured. We found serum PTH levels showed an improvement after the treatment with etelcalcetide again paricalcitol and no treatment (p < 0.04). Of note, serum levels of CRP were significantly lower in a small group of patients (n = 11) receiving paricalcitol + etelcalcetide compared to paricalcitol or etelcalcetide alone. The proportion of patients with CRP within target ranges ( 1.0 mg/dL) increased significantly after combined treatment (p < 0.001). Conclusions: etelcalcetide proved to safely reduce the PTH levels without significant adverse events and the possibility of a synergic anti-inflammatory effect with the simultaneous use of Paricalcitol in HD patients. |
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2022 |
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2022 |
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2023-08-30T18:12:30Z |
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2023-08-30T18:12:30Z |
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info:eu-repo/semantics/article |
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Artículo científico |
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D’Marco, L.; Checa-Ros, A.; Gamero, D.; Soto, C.; Salazar, J.; Nava, M.; Bermúdez, V.; Dapena, F. Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation. Healthcare 2023, 11, 72. https://doi.org/ 10.3390/healthcare11010072 |
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22279032 |
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https://hdl.handle.net/20.500.12442/13230 |
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https://doi.org/10.3390/healthcare11010072 |
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D’Marco, L.; Checa-Ros, A.; Gamero, D.; Soto, C.; Salazar, J.; Nava, M.; Bermúdez, V.; Dapena, F. Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation. Healthcare 2023, 11, 72. https://doi.org/ 10.3390/healthcare11010072 22279032 |
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https://hdl.handle.net/20.500.12442/13230 https://doi.org/10.3390/healthcare11010072 |
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eng |
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eng |
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Attribution-NonCommercial-NoDerivatives 4.0 Internacional |
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pdf |
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Vol. 11 No. 72 (2023) |
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D’Marco, Luisb847abd0-611f-4212-9d68-bf44069a7da7Checa-Ros, Ana37ccfc0f-1ac1-470e-9c32-6373bff2a413Gamero, Dionilux1a61dc7f-ba47-4271-b380-95d7da3d159eSoto, Carlos7ffd9571-c0f5-4157-9e72-07cc8779b86bSalazar, Juanfbd053e7-5aea-424c-812f-92153ecb9181Nava, Manuelcf0ca570-5fc3-4ec7-9913-90be952261e2Bermúdez, Valmore29f9aa18-16a4-4fd3-8ce5-ed94a0b8663aDapana, Fabiolae0a13d1a-c77a-4c88-a647-b3a190fea3322023-08-30T18:12:30Z2023-08-30T18:12:30Z2022D’Marco, L.; Checa-Ros, A.; Gamero, D.; Soto, C.; Salazar, J.; Nava, M.; Bermúdez, V.; Dapena, F. Etelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammation. Healthcare 2023, 11, 72. https://doi.org/ 10.3390/healthcare1101007222279032https://hdl.handle.net/20.500.12442/13230https://doi.org/10.3390/healthcare11010072Introduction: secondary hyperparathyroidism (SHP) is frequent in patients with chronic kidney disease (CKD), particularly in those in dialysis. To treat this complication, the current options available include phosphorus restriction, phosphate binders, the inhibition of parathyroid hormone (PTH) synthesis and secretion by the supplementation of vitamin D or VDR activators, or the use of calcimimetics. Beyond the control of PTH, the effects of the treatment of SHP on other biomarkers of risk may represent an additional benefit for this population. In this study, we explore the benefits of current SHP treatment options, mainly paricalcitol and/or etelcalcetide in the inflammatory state of hemodialysis (HD) patients. Results: the study finally included 142 maintenance HD patients (5 patients were excluded) followed for 6 months (dialysis vintage 26 30 months, mean age 70 years old, 73% women, 81% Spanish white, 47% diabetic). In this case, 52 patients were on regular treatment with paricalcitol for SHP and 25 patients were eligible to initiate etelcalcetide. The baseline serum levels of Ca, P, PTH, Ferritin, albumin, C-reactive protein (CRP), and other variables were measured. We found serum PTH levels showed an improvement after the treatment with etelcalcetide again paricalcitol and no treatment (p < 0.04). Of note, serum levels of CRP were significantly lower in a small group of patients (n = 11) receiving paricalcitol + etelcalcetide compared to paricalcitol or etelcalcetide alone. The proportion of patients with CRP within target ranges ( 1.0 mg/dL) increased significantly after combined treatment (p < 0.001). Conclusions: etelcalcetide proved to safely reduce the PTH levels without significant adverse events and the possibility of a synergic anti-inflammatory effect with the simultaneous use of Paricalcitol in HD patients.pdfengMDPIAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2HealthcareVol. 11 No. 72 (2023)calcimimetics; vitamin D analogs; chronic kidney disease; inflammationEtelcalcetide and Paricalcitol in Chronic Kidney Disease: When the Target Is Inflammationinfo:eu-repo/semantics/articleArtículo científicohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_2df8fbb1Torres, P.A.U.; De Broe, M. Calcium-Sensing Receptor, Calcimimetics, and Cardiovascular Calcifications in Chronic Kidney Disease. Kidney Int. 2012, 82, 19–25. [Levin, A.; Bakris, G.L.; Molitch, M.; Smulders, M.; Tian, J.; Williams, L.A.; Andress, D.L. Prevalence of Abnormal Serum Vitamin D, PTH, Calcium, and Phosphorus in Patients with Chronic Kidney Disease: Results of the Study to Evaluate Early Kidney Disease. Kidney Int. 2007, 71, 31–38.Herzog, C.A.; Asinger, R.W.; Berger, A.K.; Charytan, D.M.; Díez, J.; Hart, R.G.; Eckardt, K.-U.; Kasiske, B.L.; McCullough, P.A.; Passman, R.S.; et al. Cardiovascular Disease in Chronic Kidney Disease. A Clinical Update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2011, 80, 572–586Eidman, K.E.;Wetmore, J.B. Treatment of secondary hyperparathyroidism: How do cinacalcet and etelcalcetide differ? Semin. Dial. 2018, 31, 440–444.Brown, A.J.; Dusso, A.S.; Slatopolsky, E. Vitamin D analogs for Secondary Hyperparathyroidism. Nephrol. Dial. Transplant. 2002, 17 (Suppl.1), 10–19.Hu, X.; Shang, J.; Yuan, W.; Zhang, S.; Jiang, Y.; Zhao, B.; Duan, Y.; Xiao, J.; Zhao, Z. Effects of Paricalcitol on Cardiovascular Outcomes and Renal Function in Patients with Chronic Kidney Disease: A Meta-Analysis. Herz 2018, 43, 518–528.Brickman, A.S.; Hartenbower, D.L.; Norman, A.W.; Coburn, J.W. Actions of 1 Alpha-Hydroxyvitamin D3 and 1,25- Dihydroxyvitamin D3 on Mineral Metabolism in Man. I. Effects on Net Absorption of Phosphorus. Am. J. Clin. Nutr. 1977, 30, 1064–1069.Block, G.A.; Chertow, G.M.; Sullivan, J.T.; Deng, H.; Mather, O.; Tomlin, H.; Serenko, M. An Integrated Analysis of Safety and Tolerability of Etelcalcetide in Patients Receiving Hemodialysis with Secondary Hyperparathyroidism. PLoS ONE 2019, 14, e0213774.Friedl, C.; Zitt, E. Role of Etelcalcetide in the Management of Secondary Hyperparathyroidism in Hemodialysis Patients: A Review on Current Data and Place in Therapy. Drug Des. Dev. Ther. 2018, 12, 1589–1598Chennasamudram, S.P.; Noor, T.; Vasylyeva, T.L. Comparison of Sevelamer and Calcium Carbonate on Endothelial Function and Inflammation in Patients on Peritoneal Dialysis. J. Ren. Care 2013, 39, 82–89Ko, S.M.; Zhang, C.; Chen, Z.; D’Marco, L.; Bellasi, A.; Stillman, A.E.; Block, G.; Raggi, P. Epicardial Adipose Tissue Volume Increase in Hemodialysis Patients Treated with Sevelamer or Calcium-Based Phosphate Binders: A Substudy of the Renagel in New Dialysis Trial. J. Nephrol. 2016, 29, 683–690.Koiwa, F.; Yokoyama, K.; Fukagawa, M.; Akizawa, T. Evaluation of Changes in Ferritin Levels during Sucroferric Oxyhydroxide Treatment. Clin. Kidney J. 2018, 12, 294–299.Otsuki, T.; Utsunomiya, K.; Moriuchi, M.; Horikoshi, S.; Okamura, M.; Suzuki, H.; Okamura, M.; Maruyama, N.; Shibahara, N.; Abe, M. Effect of Sucroferric Oxyhydroxide on Fibroblast Growth Factor 23 Levels in Hemodialysis Patients. Nephron 2018, 140, 161–168.Chang, Y.-M.; Tsai, S.-C.; Shiao, C.-C.; Liou, H.-H.; Yang, C.-L.; Tung, N.-Y.; Hsu, K.-S.; Chen, I.-L.; Liu, M.-C.; Kao, J.-L.; et al. Effects of Lanthanum Carbonate and Calcium Carbonate on Fibroblast Growth Factor 23 and Hepcidin Levels in Chronic Hemodialysis Patients. Clin. Exp. Nephrol. 2016, 21, 908–916Chang, Y.-M.; Tsai, S.-C.; Shiao, C.-C.; Liou, H.-H.; Yang, C.-L.; Tung, N.-Y.; Hsu, K.-S.; Chen, I.-L.; Liu, M.-C.; Kao, J.-L.; et al. Effects of Lanthanum Carbonate and Calcium Carbonate on Fibroblast Growth Factor 23 and Hepcidin Levels in Chronic Hemodialysis Patients. Clin. Exp. Nephrol. 2016, 21, 908–916Rojas-Rivera, J.; De La Piedra, C.; Ramos, A.; Ortiz, A.; Egido, J. The Expanding Spectrum of Biological Actions of Vitamin D. Nephrol. Dial. Transplant. 2010, 25, 2850–2865.Skaaby, T.; Husemoen, L.L.N.; Thuesen, B.H.; Pisinger, C.; Jørgensen, T.; Roswall, N.; Larsen, S.C.; Linneberg, A. Prospective Population-Based Study of the Association between Serum 25-Hydroxyvitamin-D Levels and the Incidence of Specific Types of Cancer. Cancer Epidemiol. Biomark. Prev. 2014, 23, 1220–1229Anderson, J.L.; May, H.T.; Horne, B.D.; Bair, T.L.; Hall, N.L.; Carlquist, J.F.; Lappé, D.L.; Muhlestein, J.B.; Intermountain Heart Collaborative (IHC) Study Group. Relation of Vitamin D Deficiency to Cardiovascular Risk Factors, Disease Status, and Incident Events in a General Healthcare Population. Am. J. Cardiol. 2010, 106, 963–968.Arici, M.;Walls, J. End-Stage Renal Disease, Atherosclerosis, and Cardiovascular Mortality: Is C-Reactive Protein the Missing Link? Kidney Int. 2001, 59, 407–414López, R.O.; de Motta, E.E.; Carmona, A.; Montemayor, V.G.; Berdud, I.; Malo, A.M.; García, P.A. Correction of 25-OH-Vitamin D Deficiency Improves Control of Secondary Hyperparathyroidism and Reduces the Inflammation in Stable Haemodialysis Patients. Nefrologia 2018, 38, 41–47.Matias, P.J.; Jorge, C.; Ferreira, C.; Borges, M.; Aires, I.; Amaral, T.; Gil, C.; Cortez, J.; Ferreira, A. Cholecalciferol Supplementation in Hemodialysis Patients: Effects on Mineral Metabolism, Inflammation, and Cardiac Dimension Parameters. Clin. J. Am. Soc. Nephrol. 2010, 5, 905–911.Bucharles, S.; Barberato, S.H.; Stinghen, A.; Gruber, B.; Piekala, L.; Dambiski, A.C.; Custodio, M.R.; Pecoits-Filho, R. Impact of Cholecalciferol Treatment on Biomarkers of Inflammation and Myocardial Structure in Hemodialysis Patients Without Hyperparathyroidism. J. Ren. Nutr. 2012, 22, 284–291.Alborzi, P.; Patel, N.A.; Peterson, C.; Bills, J.E.; Bekele, D.M.; Bunaye, Z.; Light, R.P.; Agarwal, R. Paricalcitol Reduces Albuminuria and Inflammation in Chronic Kidney Disease: A Randomized Double-Blind Pilot Trial. Hypertens 2008, 52, 249–255Navarro-Gonzalez, J.F.; Donate-Correa, J.; Méndez, M.L.; De Fuentes, M.M.; García-Pérez, J.; Mora-Fernández, C. Anti- Inflammatory Profile of Paricalcitol in Hemodialysis Patients: A Prospective, Open-Label, Pilot Study. J. Clin. Pharmacol. 2013, 53, 421–426.Navarro-Gonzalez, J.F.; Donate-Correa, J.; Méndez, M.L.; De Fuentes, M.M.; García-Pérez, J.; Mora-Fernández, C. Anti- Inflammatory Profile of Paricalcitol in Hemodialysis Patients: A Prospective, Open-Label, Pilot Study. J. Clin. Pharmacol. 2013, 53, 421–426.Block, G.A.; Martin, K.J.; de Francisco, A.L.; Turner, S.A.; Avram, M.M.; Suranyi, M.G.; Hercz, G.; Cunningham, J.; Abu-Alfa, A.K.; Messa, P.; et al. Cinacalcet for Secondary Hyperparathyroidism in Patients Receiving Hemodialysis. N. Engl. J. Med. 2004, 350, 1516–1525. [Raggi, P.; Chertow, G.M.; Torres, P.U.; Csiky, B.; Naso, A.; Nossuli, K.; Moustafa, M.; Goodman,W.G.; Lopez, N.; Downey, G.; et al. The ADVANCE study: A randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis. Nephrol. Dial. Transplant. 2010, 26, 1327–1339Parfrey, P.S.; Chertow, G.M.; Block, G.A.; Correa-Rotter, R.; Drüeke, T.B.; Floege, J.; Herzog, C.A.; London, G.M.; Mahaffey, K.W.; Moe, S.M.; et al. The Clinical Course of Treated Hyperparathyroidism among Patients Receiving Hemodialysis and the Effect of Cinacalcet: The Evolve Trial. J. Clin. Endocrinol. Metab. 2013, 98, 4834–4844Cunningham, J.; Block, G.A.; Chertow, G.M.; Cooper, K.; Evenepoel, P.; Iles, J.; Sun, Y.; Ureña-Torres, P.; Bushinsky, D.A. Etelcalcetide Is Effective at All Levels of Severity of Secondary Hyperparathyroidism in Hemodialysis Patients. Kidney Int. Rep. 2019, 4, 987–994.Shigematsu, T.; Fukagawa, M.; Yokoyama, K.; Akiba, T.; Fujii, A.; Odani, M.; Akizawa, T. Effects of the Intravenous Calcimimetic Etelcalcetide on Bone Turnover and Serum Fibroblast Growth Factor 23: Post Hoc Analysis of an Open-label Study. Clin. Ther. 2018, 40, 2099–2111.Yu, L.; Tomlinson, J.E.; Alexander, S.T.; Hensley, K.; Han, C.-Y.; Dwyer, D.; Stolina, M.; Dean, C.; Goodman, W.G.; Richards, W.G.; et al. Etelcalcetide, A Novel Calcimimetic, Prevents Vascular Calcification in A Rat Model of Renal Insufficiency with Secondary Hyperparathyroidism. Calcif. 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