Misiorowski Waldemar, Zgliczyński Wojciech
Department of Endocrinology, Centre of Postgraduate Medical Education Bielański Hospital, Warsaw, Poland, Poland.
Endokrynol Pol. 2017;68(3):306-310. doi: 10.5603/EP.2017.0023.
The aim of presented study was to assess the efficacy of cinacalcet in reducing serum calcium concentrations in primary hyperparathyroid (PHPT) patients with hypercalcaemia exceeding 12.5 mg/dL, awaiting parathyroidectomy.
The study included 23 patients with PHPT with hypercalcaemia > 12.5 mg/dL, qualified for surgery. We recorded clinical and biochemical data at baseline, and after every week of treatment. We also monitored adverse events. Cinacalcet was adminis-tered in increasing doses until the corrected serum calcium concentration was 11.3 mg/dL or less, the patient reached the highest possible dosage of 90 mg four times daily, or the patient experienced an adverse event that precluded further dosage increases.
The primary end point of reduction in corrected serum calcium concentration to 11.3 mg/dL was achieved in 19 patients (83%), and normocalcaemia (S-Ca < 10.3 mg/dL) was achieved in 55% of patients. The medication was usually well tolerated (83.4%). Most common adverse events were nausea and vomiting, especially at the beginning of therapy; however, only one patient withdrew from the study because of adverse events.
Cinacalcet rapidly reduced serum calcium in PHPT patients with severe hypercalcaemia and can be useful as a short-term pretreatment prior to surgery, allowing the completion of diagnostics and safe awaiting for operation.
本研究的目的是评估西那卡塞在降低血清钙浓度方面对血钙超过12.5mg/dL、等待甲状旁腺切除术的原发性甲状旁腺功能亢进症（PHPT）患者的疗效。
该研究纳入了23例血钙>12.5mg/dL、符合手术条件的PHPT患者。我们在基线时以及治疗的每周后记录临床和生化数据。我们还监测不良事件。西那卡塞的给药剂量逐渐增加，直到校正后的血清钙浓度为11.3mg/dL或更低、患者达到每日4次90mg的最高可能剂量，或者患者出现阻止进一步增加剂量的不良事件。
19例患者（83%）实现了将校正后的血清钙浓度降至11.3mg/dL的主要终点，55%的患者实现了血钙正常（S-Ca<10.3mg/dL）。该药物通常耐受性良好（83.4%）。最常见的不良事件是恶心和呕吐，尤其是在治疗开始时；然而，只有一名患者因不良事件退出研究。
西那卡塞可迅速降低重度高钙血症的PHPT患者的血清钙水平，可作为手术前的短期预处理药物，有助于完成诊断并安全等待手术。
