Reduction in parathyroid adenomas by cinacalcet therapy in patients with primary hyperparathyroidism.

Midori Minezaki, Yuichi Takashi, Kentaro Ochi, Ryo Mitsuoka, Yuka Yamao, Tadachika Kudo, Daiji Kawanami, Kunihisa Kobayashi, Ichiro Abe

Journal of bone and mineral metabolism 2021 Jul

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Cinacalcet is a calcimimetic that modulates the functions of calcium-sensing receptor and is currently used to treat patients with primary hyperparathyroidism (PHPT). Although it was reported that cinacalcet treatment reduced the size of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism, whether or not cinacalcet treatment can reduce the size of parathyroid adenomas in patients with PHPT has been unknown. We recruited nine (male: one, female: eight) patients with PHPT due to parathyroid adenomas who did not undergo parathyroidectomy. Cinacalcet was administered at a dose of 50 mg/day, and we evaluated the size of parathyroid adenomas (width × thickness) (mm2) using ultrasonography before and after 6 months of cinacalcet treatment. The mean age of the subjects was 58.1 ± 7.2 years old, and the mean serum intact parathyroid hormone (PTH) concentration was 134.8 ± 8.7 pg/ml. All participants showed hypercalcemia and osteopenia. After 6 months, the mean size of parathyroid adenomas was significantly decreased (baseline: 73.8 ± 33.4 mm2 vs. after 6 months: 52.5 ± 25.0 mm2, p = 0.045). Thus, 6-month cinacalcet treatment induced a 29% size reduction in parathyroid adenomas. Furthermore, the serum intact PTH concentration before cinacalcet treatment was positively correlated with the reduction in the size of parathyroid adenomas. The present study revealed that cinacalcet treatment reduces the size of parathyroid adenomas in patients with PHPT. The accumulation of more PHPT cases with cinacalcet therapy is required to confirm this finding.

Citation

Midori Minezaki, Yuichi Takashi, Kentaro Ochi, Ryo Mitsuoka, Yuka Yamao, Tadachika Kudo, Daiji Kawanami, Kunihisa Kobayashi, Ichiro Abe. Reduction in parathyroid adenomas by cinacalcet therapy in patients with primary hyperparathyroidism. Journal of bone and mineral metabolism. 2021 Jul;39(4):583-588