Impact of upacicalcet on bone metabolism in hemodialysis patients with secondary hyperparathyroidism: a post-hoc analysis
Abstract
Secondary hyperparathyroidism (SHPT) is a complication prevalent among patients undergoing hemodialysis (HD). Upacicalcet, a novel intravenous calcimimetic agent, has demonstrated efficacy in improving bone turnover by suppressing PTH production. However, the influence of baseline bone metabolism on the efficacy of calcimimetics remains unclear. Therefore, we aimed to evaluate the efficacy of upacicalcet on PTH suppression and changes in bone turnover based on bone-specific alkaline phosphatase (BAP) levels. This study involved a post-hoc analysis of data from a phase 3, placebo-controlled, double-blind trial evaluating the effect of upacicalcet in HD patients with SHPT. Patients were categorized into 3 groups based on tertiles of baseline serum BAP levels. Key biomarkers, including serum levels of intact PTH (iPTH), BAP, tartrate-resistant acid phosphatase-5b (TRACP-5b), and BAP/TRACP-5b ratio, were measured. Percentage changes from baseline in these parameters were assessed using a mixed-effects model for repeated measures. Additionally, cases of increased serum BAP levels following upacicalcet administration were investigated. A total of 103 HD patients with SHPT treated with upacicalcet were included in the analysis. Patients were categorized into low BAP (18.8 μg/L) groups. After 24 wk of upacicalcet intervention, iPTH levels decreased across all baseline BAP groups. Serum BAP and TRACP-5b levels decreased, whereas the BAP/TRACP-5b ratio increased across all groups.…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 103 participants or records.
Read the paper
Related studies
- Irisin Enhances Osteoblast DifferentiationIn Vitro
- Glucocorticoids suppress Wnt16 expression in osteoblasts in vitro and in vivo
- Interaction between Schwann Cells and Osteoblasts In Vitro
- Administration of cinnamaldehyde promotes osteogenesis in ovariectomized rats and differentiation of osteoblast in vitro
- The Effect of the Major Components of Fructus Cnidii on Osteoblasts In Vitro
- Estrogen depletion alters osteogenic differentiation and matrix production by osteoblasts in vitro
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.