Changes in Bone Quality after Treatment with Etelcalcetide

What is it about?

Secondary hyperparathyroidism is a complication of kidney disease that damages bone quality, increasing risk of fractures. We tested if 36 weeks of parathyroid hormone (PTH) suppression with the intravenous calcimimetic etelcalcetide mitigated the skeletal effects of hyperparathyroidism. In a single-arm open-label prospective pilot trial, thirteen patients underwent pre- and post-treatment skeletal imaging. 5 patients underwent quadruple label bone biopsy. Over the course of treatment, bone mineral density increased at the spine, femoral neck and total hip. Bone biopsy demonstrated decreases in bone formation rate. Treatment of secondary hyperparathyroidism with etelcalcetide was associated with improvements in bone mineral density and corrected high turnover bone disease. Further studies are needed to determine the effects of PTH reduction by etelcalcetide on fracture resistance.

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