Introduction: In primary hyperparathyroidism (PHPT) medical treatment is indicated if the patient donot carry out the surgical criterion, donot accept surgery or there is another serious comorbidity that makes impossible the intervention. Cinacalcet is a calcimimetic that increase the sensitivity of the calcium-sensing receptor (CaSR) to ionized serum calcium, decreasing secretion of PTH and serum calcium concentration. This drug is prescribed for secondary hyperparathyroidism in patients with dialysis and in parathyroid carcinoma. Recent trials suggests it use in the treatment of PHPT.
Objective: To show our experience about the use of Cinacalcet for the treatment of persistent PHPT.
Patients and methods: Three patients (women), age range between 50 and 61 years, diagnosed of persistent PHPT after surgery. The mean time of monitoring was 3 years (range 26). Reasons to start Cinacalcet (initial dose 30 mg/12 h): failure of the second surgery, patient 1; gastric cancer and patients rejection to another surgery, patient 2; serious local fibrosis secondary to previous surgery (thyroid and parathyroid) and patients rejection to another intervention, patient 3. In two patients previous treatment with biphosphonates failed.
Results: Cinacalcet caused a mean decrease of 2.1 mg/dl (range 1.72.8) in serum calcium concentration, without effect in PTH level.
Conclusion: Cinacalcet is an effective alternative in non-surgical treatment of PHPT. We need more studies to know it effects about mineral bone density and quality of life.
03 - 07 May 2008
European Society of Endocrinology