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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Comparative Effectiveness and Safety of Etelcalcetide and Cinacalcet in Hemodialysis Patients with Secondary Hyperparathyroidism: A Multicenter Retrospective Cohort Study

  • Engin Onan1
  • Emrah Günay2
  • Derya Basak Tanburoglu2
  • Ilter Bozaci3
  • Mehmet Horoz2
  • Ruya Kozanoglu1
  • Hasan Micozkadioglu1
  • Refik Olmaz4
  • Ramazan Danis5
  • Kutlay Tutucu6
  • Dilek Torun1
6 affiliations
  1. 1Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Training and Research Hospital, 01250 Adana, Türkiye
  2. 2Department of Nephrology, Adana City Training and Research Hospital, 01230 Adana, Türkiye
  3. 3Department of Nephrology, Antalya City Training and Research Hospital, 07080 Antalya, Türkiye
  4. 4Department of Nephrology, Mersin City Training and Research Hospital, 33240 Mersin, Türkiye
  5. 5Department of Nephrology, Diyarbakir Gazi Yasargil Training and Research Hospital, 21070 Diyarbakir, Türkiye
  6. 6Department of Nephrology, Toros Devlet Hospital, 33050 Mersin, Türkiye
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Abstract

Background: Etelcalcetide and cinacalcet are widely used for the treatment of secondary hyperparathyroidism (sHPT) in patients receiving maintenance hemodialysis. This study compared their real-world biochemical effectiveness and adverse-event profiles over 12 months. Methods: This multicenter retrospective cohort study included 116 hemodialysis patients with sHPT treated at five dialysis centers. Sixty-three patients received intravenous etelcalcetide and 53 received oral cinacalcet. The primary outcome was the between-group difference in the percentage change in parathyroid hormone (PTH) from baseline to 12 months. Secondary outcomes included longitudinal changes in corrected calcium, phosphorus, albumin, and C-reactive protein levels and the incidence of treatment-related adverse events. Results: Baseline PTH levels were higher in the etelcalcetide group than in the cinacalcet group (1562 vs. 1268 pg/mL, p = 0.011). PTH levels decreased during the first 3 months and subsequently fluctuated in both groups. The mean 12-month percentage change in PTH was −17.52% in the cinacalcet group and −14.13% in the etelcalcetide group (between-group mean difference, 3.39 percentage points; 95% CI, −20.36 to 27.14; p = 0.776). Hypocalcemia occurred more frequently with etelcalcetide than with cinacalcet (52% vs. 32%, p = 0.028). In contrast, nausea (68% vs. 2%, p = 0.001) and vomiting (8% vs. 0%, p = 0.026) were more frequent with cinacalcet. Conclusions: No statistically significant difference in the 12-month percentage change in PTH was observed between etelcalcetide and cinacalcet, although baseline PTH levels were higher in the etelcalcetide group. The treatments demonstrated distinct adverse-event profiles, with more frequent hypocalcemia during etelcalcetide treatment and more frequent gastrointestinal adverse events during cinacalcet treatment. These findings describe biochemical outcomes and adverse-event frequencies among patients who remained on treatment for at least 3 months; they do not establish therapeutic equivalence or comparative safety.

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Cite

BibTeXRIS
BibTeX
@article{onan2026comparative,
  title = {{Comparative Effectiveness and Safety of Etelcalcetide and Cinacalcet in Hemodialysis Patients with Secondary Hyperparathyroidism: A Multicenter Retrospective Cohort Study}},
  author = {Engin Onan and Emrah Günay and Derya Basak Tanburoglu and Ilter Bozaci and Mehmet Horoz and Ruya Kozanoglu and Hasan Micozkadioglu and Refik Olmaz and Ramazan Danis and Kutlay Tutucu and Dilek Torun},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218271},
  url = {https://www.mdpi.com/2077-0383/15/21/8271},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Comparative Effectiveness and Safety of Etelcalcetide and Cinacalcet in Hemodialysis Patients with Secondary Hyperparathyroidism: A Multicenter Retrospective Cohort Study
AU  - Engin Onan
AU  - Emrah Günay
AU  - Derya Basak Tanburoglu
AU  - Ilter Bozaci
AU  - Mehmet Horoz
AU  - Ruya Kozanoglu
AU  - Hasan Micozkadioglu
AU  - Refik Olmaz
AU  - Ramazan Danis
AU  - Kutlay Tutucu
AU  - Dilek Torun
PY  - 2026
DA  - 2026/10/23
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218271
UR  - https://www.mdpi.com/2077-0383/15/21/8271
AB  - Background: Etelcalcetide and cinacalcet are widely used for the treatment of secondary hyperparathyroidism (sHPT) in patients receiving maintenance hemodialysis. This study compared their real-world biochemical effectiveness and adverse-event profiles over 12 months. Methods: This multicenter retrospective cohort study included 116 hemodialysis patients with sHPT treated at five dialysis centers. Sixty-three patients received intravenous etelcalcetide and 53 received oral cinacalcet. The primary outcome was the between-group difference in the percentage change in parathyroid hormone (PTH) from baseline to 12 months. Secondary outcomes included longitudinal changes in corrected calcium, phosphorus, albumin, and C-reactive protein levels and the incidence of treatment-related adverse events. Results: Baseline PTH levels were higher in the etelcalcetide group than in the cinacalcet group (1562 vs. 1268 pg/mL, p = 0.011). PTH levels decreased during the first 3 months and subsequently fluctuated in both groups. The mean 12-month percentage change in PTH was −17.52% in the cinacalcet group and −14.13% in the etelcalcetide group (between-group mean difference, 3.39 percentage points; 95% CI, −20.36 to 27.14; p = 0.776). Hypocalcemia occurred more frequently with etelcalcetide than with cinacalcet (52% vs. 32%, p = 0.028). In contrast, nausea (68% vs. 2%, p = 0.001) and vomiting (8% vs. 0%, p = 0.026) were more frequent with cinacalcet. Conclusions: No statistically significant difference in the 12-month percentage change in PTH was observed between etelcalcetide and cinacalcet, although baseline PTH levels were higher in the etelcalcetide group. The treatments demonstrated distinct adverse-event profiles, with more frequent hypocalcemia during etelcalcetide treatment and more frequent gastrointestinal adverse events during cinacalcet treatment. These findings describe biochemical outcomes and adverse-event frequencies among patients who remained on treatment for at least 3 months; they do not establish therapeutic equivalence or comparative safety.
SN  - 2077-0383
ER  -