Medical treatment with cinacalcet in primary hyperparathyroidism

Mairead T Crowley; Deirdre Green; Oghenekevwe Uyovbisere; Ruth Cullen; Maria Byrne; Mensud Hatunic; Brendan Kinsley; Recie Davern; Siobhan McQuaid; Paula M. O; Nigel Glynn

doi:10.1530/endoabs.115.EP41

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Endocrine Abstracts (2026) 115 EP41 | DOI: 10.1530/endoabs.115.EP41

IES2025 Research, Audit and Quality Improvement Projects E-Posters (60 abstracts)

Medical treatment with cinacalcet in primary hyperparathyroidism

Mairéad T Crowley , Deirdre Green , Oghenekevwe Uyovbisere , Ruth Cullen , Maria Byrne , Mensud Hatunic , Brendan Kinsley , Recie Davern , Siobhán McQuaid , Paula M. O’Shea & Nigel Glynn

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Mater Misericordiae University hospital, Dublin, Ireland

Cinacalcet lowers serum/plasma calcium in primary hyperparathyroidism (PHPT), but short-term effects on bone mineral density (BMD) are unclear. We sought to assess its efficacy and tolerability in outpatients with PHPT at our centre Ninety patients (mean age 66.3 ± 11.7 years) were identified, with baseline adjusted calcium 2.77 ± 0.10 mmol/l/l, parathyroid hormone (PTH) 10.7 ± 4.4 pmol/l, and 25-hydroxyvitamin D levels of 64 ± 36 nmol/l. Twenty-three patients (26%) commenced cinacalcet, resulting in a significant reduction in adjusted calcium (2.77 ± 0.06 vs 2.57 ± 0.14 mmol/l/l, P < 0.001) and increased phosphate (0.79 ± 0.01 vs 0.87 ± 0.11 mmol/l/l, P = 0.0023). PTH reduction was not statistically significant (13.5 ± 5.7 vs 12.1 ± 5.3 pmol/l, P = 0.05) Cinacalcet recipients had higher baseline adjusted calcium than non-recipients (2.76 ± 0.07 vs 2.67 ± 0.08 mmol/l/l, P < 0.0001), with no differences in age or PHPT duration. Mean treatment duration was 3.1 ± 3.0 years (range 0.6–13.4 years). BMD did not significantly change (–1.7 ± 1.6 vs –2.1 ± 1.5, P = 0.59). Five patients also received antiresorptive and 25-hydroxyvitamin D therapy. Two had a history of renal calculi prior to cinacalcet. Adverse effects included gastrointestinal symptoms (n = 1) and hypocalcaemia (n = 2). Cinacalcet effectively reduced adjusted calcium in PHPT without significant impact on BMD during follow-up.