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Endocrine Abstracts (2019) 65 P80 | DOI: 10.1530/endoabs.65.P80

SFEBES2019 POSTER PRESENTATIONS Bone and calcium (51 abstracts)

Assessing the use of Cinacalcet for conservative management of primary hyperparathyroidism in a regional district general hospital

Neil Patrick Kelly 1 & Anjali Santhakumar 2


1Aintree University Hospital, Liverpool, UK; 2Macclesfield District General Hospital, Macclesfield, UK


Background: The treatment of choice for symptomatic primary hyperparathyroidism (PHPT) is surgery, however in many cases patient choice or medical comorbidities preclude this treatment modality.

Aim: This audit examines the use of cinacalcet in management of primary hyperparathyroidism in a district general hospital to determine if it is in accordance with the National institute for health and care excellence (NICE) guidance (May 2019).

Method: We retrospectively analysed the data for all patients diagnosed with PHPT and treated with Cinacalcet in a district general hospital over a 12 month period.

Results: 16 patients (10 female) were prescribed cinacalcet with an average age of 76. 100% of patients had calcium levels above 2.85 with symptoms or end organ damage, replete vitamin D levels and parathyroid hormone levels in keeping with PHPT. Urinary calcium:creatinine excretion ratio was appropriately screened to exclude familial hypocalciuric hypercalcaemia (FHH) in 14{87.5%} patients. 1{6.25%} patient was receiving cinacalcet for symptomatic FHH. 8{50%} patients were deemed unfit for surgery whilst 3{18.75%} are awaiting surgery. 2{12.5%} patients underwent unsuccessful surgery. 3/16{18.75%} patients refused Surgery. 10{62.5%} patients achieved a normalisation in calcium post cinacalcet treatment. 14{87.5%} patients had renal imaging with a total of 2{12.5%} having renal Calculi identified. In total 87.5% of cinacalcet prescriptions were compliant with NICE guidance. 16{100%} patients received a DEXA scan within 6 months of first clinic review

Conclusions: The study finds the majority of patients were able to achieve a normalisation in calcium following cinacalcet treatment. Predominantly cinacalcet was appropriately administered in accordance with NICE guidance. The results showed that cinacalcet had also been used as a bridging agent prior to definitive surgical intervention. This shows not all Cinacalcet prescriptions were compliant with NICE guidance but were deemed clinically necessary to prevent worsening hypercalcaemia.

Volume 65

Society for Endocrinology BES 2019

Brighton, United Kingdom
11 Nov 2019 - 13 Nov 2019

Society for Endocrinology 

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