Clinical Use of Cinacalcet in MEN1 HyperparathyroidismReport as inadecuate




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International Journal of EndocrinologyVolume 2010 2010, Article ID 906163, 4 pages

Clinical StudyDepartment of Endocrinology, St. Bartholomew-s Hospital, London EC1A 7BE, UK

Received 29 December 2009; Accepted 8 March 2010

Academic Editor: Aaron I. Vinik

Copyright © 2010 V. J. Moyes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Management of multiple-endocrine neoplasia type 1- MEN1- associated hyperparathyroidism is associated with high recurrence rates and high surgical morbidity due to multiple neck explorations. Cinacalcet, a calcimimetic agent licensed for the treatment of secondary hyperparathyroidism and parathyroid carcinoma, may provide a medical alternative for the management of these complex patients. Methods. A prospective audit was performed of eight patients; three males and five females, aged 20–38 at diagnosis. Two patients commenced cinacalcet as primary treatment and six had previous surgery. Six patients had complications of hyperparathyroidism: renal calculi, renal dysfunction, and reduced bone mineral density. All were commenced on cinacalcet 30 mg bd for MEN1 associated hyperparathyroidism; doses were subsequently reduced to 30 mg od in four patients. Results. Significant reductions were observed in serum calcium and PTH measurements. Serum calcium reduced by a median of 0.35 mmol-L Wilcoxon Signed Rank. Serum PTH levels decreased by a median of 5.05 pmol-L . There was no change in urine calcium. Duration ranged from 10–35 months with maintenance of control. Cinacalcet was well tolerated by six patients; one experienced nausea and one experienced diarrhoea. Conclusion. Cinacalcet is an effective and well-tolerated medical treatment for the management of complex primary hyperparathyroidism.





Author: V. J. Moyes, J. P. Monson, S. L. Chew, and S. A. Akker

Source: https://www.hindawi.com/



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