An open-label study to evaluate a single-dose of cinacalcet in pediatric dialysis subjects

Pediatr Nephrol. 2012 Oct;27(10):1953-9. doi: 10.1007/s00467-012-2186-9. Epub 2012 May 26.

Abstract

Background: There is limited knowledge of the effectiveness and safety profile of cinacalcet in pediatric patients with secondary hyperparathyroidism (sHPT) treated with dialysis.

Methods: This was an open-label, single-dose study conducted on 12 pediatric subjects with chronic kidney disease treated with dialysis. Subjects were stratified by four age cohorts and given a single 15-mg oral dose of cinacalcet. Multiple blood samples were collected up to 72 h post-dose for the assessment of serum calcium (Ca), serum intact parathyroid hormone (iPTH), and plasma cinacalcet concentrations.

Results: Overall, cinacalcet was well tolerated with no serious adverse events. Mean (standard deviation) percentage change in serum Ca over the first 12 h post-dose was -2.93 % (5.70 %) with a nadir of -4.34 % (6.04 %) at 8 h; Ca values returned to baseline by 48 h post-dose. Mean percentage change in iPTH over the first 12 h post-dose was 57.94 % (71.82 %) with a nadir of -35.65 % (55.82 %) at 2 h. There was an inverse relationship between peak serum Ca concentration and body surface area (BSA) (r (2) = 0.41), although no relationship was found between area under the curve and age or BSA.

Conclusions: These data support future analysis to determine the therapeutic starting dose of cinacalcet for pediatric patients with sHPT on dialysis.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Administration, Oral
  • Adolescent
  • Age Factors
  • Area Under Curve
  • Biomarkers / blood
  • Body Surface Area
  • Calcimimetic Agents / administration & dosage*
  • Calcimimetic Agents / adverse effects
  • Calcimimetic Agents / blood
  • Calcimimetic Agents / pharmacokinetics
  • Calcium / blood
  • Child
  • Cinacalcet
  • Drug Dosage Calculations
  • Female
  • Humans
  • Hyperparathyroidism, Secondary / blood
  • Hyperparathyroidism, Secondary / drug therapy*
  • Hyperparathyroidism, Secondary / etiology
  • Male
  • Naphthalenes / administration & dosage*
  • Naphthalenes / adverse effects
  • Naphthalenes / blood
  • Naphthalenes / pharmacokinetics
  • Parathyroid Hormone / blood
  • Prospective Studies
  • Renal Dialysis* / adverse effects
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / therapy*
  • Treatment Outcome
  • United States

Substances

  • Biomarkers
  • Calcimimetic Agents
  • Naphthalenes
  • PTH protein, human
  • Parathyroid Hormone
  • Calcium
  • Cinacalcet