ETELCALCETIDE – A STEP FORWARD IN THE TREATMENT OF SECONDARY HYPERPARATHYROIDISM

 

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ETELCALCETIDE – A STEP FORWARD IN THE TREATMENT OF SECONDARY HYPERPARATHYROIDISM

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Snezana
Pesic
Snezana Pesic snezana.pesic74@gmail.com Zvezdara University Clinical Hospital Clinical Department of Nephrology Belgrade Serbia *
Radomir Naumovic radomirnaumovic450@gmail.com Zvezdara University Clinical Hospital, Faculty of Medicine, University of Belgrade Clinical Department of Nephrology Belgrade Serbia -
 
 
 
 
 
 
 
 
 
 
 
 
 

Secondary hyperparathyroidism (SHPT) is one of the major risk factors for cardiovascular disease (CVD) in hemodialysis patients. Effective SHPT treatment remains a crucial challenge in reducing morbidity and mortality of these patients. Beside of dietary measures, phosphate binders, and vitamin D₃ analogs, the introduction of calcimimetics has significantly transformed the therapeutic landscape, improving both biochemical control and patient adherence. This study aimed to evaluate the efficacy and safety of etelcalcetide in achieving and maintaining target levels of parathyroid hormone (PTH), calcium, and phosphate in chronic hemodialysis patients.

A prospective study followed 41 chronic hemodialysis patients with SHPT during five years period2021–2025). PTH, calcium, and phosphate levels were measured during etelcalcetide treatment, as well asand adverse events such as hypocalcemia or treatment interruption.

Forty-one patients (56.1% male, mean age 58.6 ± 12.6 years, mean dialysis vintage 109.6 ± 70.5 months) received etelcalcetide during 18.3 ± 12.7 months at 8.5 ± 3.7 mg three times weekly. Baseline PTH was 1094 ± 502 pg/mL, decreasing to 474.3 ± 331.9 pg/mL at the end of follow-up (t = 7.13; p < 0.001). The mean reduction was 50.4% (max > 94%). Asymptomatic hypocalcemia occurred in 5 patients and was managed conservatively. Oone patient required treatment discontinuation due to PTH less than 100 pg/mL.

Etelcalcetide therapy in hemodialysis patients provides a significant reduction in PTH and better SHPT control with excellent tolerability. These results confirm etelcalcetide as a meaningful step forward in the modern management of SHPT.

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