Efficacy of cinacalcet for end-stage renal disease patients with secondary hyperparathyroidism:a Meta-analysis / 天津医药

ABSTRACT

Objective To evaluate the efficacy and safety of cinacalcet on secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). Methods Patients with ESRD and SHPT for the treatment with calcimimetic agents were included in this study. MEDLINE (1996.1-2014.9), OVID (1963.1-2014.9), Chinese Wanfang database (1996.1-2014.9), CNKI (1996.1-2014.9) and the clinical control test database of Cochrane Library were searched . Related literature, including published or unpublished papers, and meeting procedding were hand-searched. Quality assessment and data extraction were conducted by two independent investigators. Meta-analysis was conducted by RevMan 5.2. Results Nineteen randomized controlled trials involving 7 702 patients were included. The meta-analysis showed that compared with conventional therapy,cinacalcet can significantly decrease serum parathyroid hormone in dialysis patients [WMD=-301.54 μg/L, 95%CI:(-344.38)-(-258.7)μg/L, P0.05). Cinacalcet increased nausea (RR =2.05, 95%CI :1.53-2.75, P0.05). Conclusion Results confirm that cinacalcet suppresses parathyroid hormone and decreases calcium and phosphorus in secondary hyperparathyroidism patients receiving dialysis. Cinacalcet increases risks of nausea, vomiting, diarrhea and hypocalcaemia,without increasing mortality.