Prescription change from cinacalcet hydrochloride to evocalcet―simultaneous switching of 147 chronic hemodialysis patients―

Abstract

[Objectives] This real-world study aimed to investigate the effects of switching from cinacalcet hydrochloride (cinacalcet) to evocalcet on serum parameters, concomitant medication usage, and upper gastrointestinal tract (GI) symptoms. [Methods] One hundred and forty-seven chronic hemodialysis patients that were taking cinacalcet were simultaneously switched to 1 mg evocalcet and followed for 8 months. A questionnaire on GI symptoms and medication adherence was carried out. [Results] After the switch, serum intact parathyroid hormone (PTH) levels increased for several months, while serum corrected calcium (Ca) levels transiently increased, but soon returned to the original levels. The cinacalcet dose just before the switch was positively correlated with change in the amplitudes of PTH and Ca. In addition, the change in the amplitude of PTH was positively correlated with the change in the amplitude of Ca, suggesting that the transient elevation of the Ca level was derived from the bone. There were no significant changes in concomitant medication usage; however, some patients stopped taking drugs that stimulate GI motility. The questionnaire indicated that the proportion of patients with GI symptoms decreased and medication adherence increased after the switch. [Conclusion] This real-world study indicates that evocalcet is a useful alternative calcimimetic drug to cinacalcet.