Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism
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 a...
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| Format: | Article |
| Language: | English |
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Wiley
2010-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2010/906163 |
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| author | V. J. Moyes J. P. Monson S. L. Chew S. A. Akker |
| author_facet | V. J. Moyes J. P. Monson S. L. Chew S. A. Akker |
| author_sort | V. J. Moyes |
| collection | DOAJ |
| description | 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 (𝑃=.012 Wilcoxon Signed Rank). Serum PTH levels decreased by a median of 5.05 pmol/L (𝑃=.012). 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. |
| format | Article |
| id | doaj-art-d473f4d57bdf4ec9a2f5b322225a4c0f |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-d473f4d57bdf4ec9a2f5b322225a4c0f2025-02-03T01:02:12ZengWileyInternational Journal of Endocrinology1687-83371687-83452010-01-01201010.1155/2010/906163906163Clinical Use of Cinacalcet in MEN1 HyperparathyroidismV. J. Moyes0J. P. Monson1S. L. Chew2S. A. Akker3Department of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, UKDepartment of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, UKDepartment of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, UKDepartment of Endocrinology, St. Bartholomew's Hospital, London EC1A 7BE, UKBackground. 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 (𝑃=.012 Wilcoxon Signed Rank). Serum PTH levels decreased by a median of 5.05 pmol/L (𝑃=.012). 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.http://dx.doi.org/10.1155/2010/906163 |
| spellingShingle | V. J. Moyes J. P. Monson S. L. Chew S. A. Akker Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism International Journal of Endocrinology |
| title | Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism |
| title_full | Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism |
| title_fullStr | Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism |
| title_full_unstemmed | Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism |
| title_short | Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism |
| title_sort | clinical use of cinacalcet in men1 hyperparathyroidism |
| url | http://dx.doi.org/10.1155/2010/906163 |
| work_keys_str_mv | AT vjmoyes clinicaluseofcinacalcetinmen1hyperparathyroidism AT jpmonson clinicaluseofcinacalcetinmen1hyperparathyroidism AT slchew clinicaluseofcinacalcetinmen1hyperparathyroidism AT saakker clinicaluseofcinacalcetinmen1hyperparathyroidism |