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Targets of Treatment for Secondary Hyperparathyroidism Not Being Met in European Dialysis Patients: Presented at ASN

By Maggie Schwarz

PHILADELPHIA -- November 9, 2008 -- Despite the wide use of drugs used to treat secondary hyperparathyroidism in European dialysis patients, less than a quarter of those patients are within guideline targets for such treatment, researchers stated at Renal Week 2008, the American Society of Nephrology (ASN) annual meeting.

Markus Ketteler, MD, University Hospital of the Rheinisch-Westfälische Technische Hochschule (RWTH), Aachen, Germany, summarized baseline treatment of secondary hyperparathyroidism in hemodialysis patients as well as its impact on bone biochemical parameters, speaking here on November 7.

Dr. Ketteler explained that the Current Management of Secondary Hyperparathyroidism: a Multicentre Observational Study (COSMOS), of which his team's analysis was a part, is an open, prospective cohort study collecting clinical parameters and outcome data from a representative sample of 4,500 hemodialysis patients from 227 medium to large facilities in 20 European countries.

At enrollment, site investigators entered selected facility and patient information into an Internet-based data-entry system, including demographics, medical history, routinely collected laboratory parameters during the previous 6 months, and concomitant treatments. Facilities and patients were identified using a stratified, random selection methodology to include 20 patients from each active facility.

A total of 86.4% of patients were taking phosphate binders; 63.4% were taking calcium-containing phosphate binders. Forty-eight percent were taking vitamin D metabolites or analogues and 30.6% vitamin D or 25(OH)D. Other medications taken for hyperparathyroidism were aluminum-containing phosphate binders, calcitriol, alpha-calcidiol, paricalcitol, and calcimimetics. Twenty-three percent of patients were taking more than one phosphate binder.

Dr. Ketteler stated that despite the wide use of drugs for the treatment of secondary hyperparathyroidism, only 22.3% of patients were within guideline targets for parathyroid hormone and calcium x phosphorus. Moreover, only 9.0% of patients were within targets for calcium, phosphorus, calcium x phosphorus, and parathyroid hormone simultaneously.

Dr. Ketteler concluded that the achievement of guideline targets is disappointingly low.

Funding for this study was supported by Amgen Inc. and the Fundación Renal Iñigo Alvarez de Toledo, Toledo, Spain.

[Presentation title: Treatment of Secondary Hyperparathyroidism and K-DOQI Guidelines Achievement. COSMOS, a European Observational Study. Abstract F-PO1795]

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