Abstract
Cinacalcet, a representative calcimimetic compound, can reduce parathyroid hormone levels, but it causes a high incidence of gastrointestinal (GI) tract-related adverse events. Evocalcet is a new calcimimetic that is expected to reduce GI symptoms. Using the Izumo scale questionnaire, we analyzed the changes in GI symptoms seen after switching from cinacalcet to evocalcet. Nineteen hemodialysis patients with secondary hyperparathyroidism were included. We prospectively analyzed their GI symptoms at three points：before they switched to evocalcet and at three and six months after they switched to evocalcet. Switching to evocalcet decreased the number of patients suffering from GI symptoms from 14 to 9 after three months and to 12 after six months. In particular, the score for the feeling of fullness significantly decreased from 0.8±1.3 points (mean ±standard deviation) before the switch to 0.7±1.5 points after three months and 0.1±1.9 points after six months (p＜0.05, respectively), and that for diarrhea also significantly decreased from 1.1±2.3 points to 0.6±1.6 points after six months (p＜0.05). Conversely, five patients without GI symptoms prior to switching to evocalcet subsequently developed GI symptoms. Evocalcet effectively ameliorated the GI symptoms of the patients who switched from cinacalcet. However, switching from cinacalcet to evocalcet may cause new GI symptoms, and it is important to be aware of this.
