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2017 ; 2
(4
): 634-644
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A Single- and Multiple-Dose, Multicenter Study of Etelcalcetide in Japanese
Hemodialysis Patients With Secondary Hyperparathyroidism
#MMPMID29142982
Yokoyama K
; Fukagawa M
; Shigematsu T
; Akiba T
; Fujii A
; Yamauchi A
; Odani M
; Akizawa T
Kidney Int Rep
2017[Jul]; 2
(4
): 634-644
PMID29142982
show ga
INTRODUCTION: The pharmacokinetics, pharmacodynamics, and safety and tolerability
profile of etelcalcetide (ONO-5163/AMG 416), a novel, i.v., long-acting
calcium-sensing receptor agonist, were studied in Japanese hemodialysis patients
with secondary hyperparathyroidism. METHODS: This multicenter, randomized,
double-blind, placebo-controlled, parallel-group study consisted of a single dose
part and a multiple dose (3 times weekly for 4 weeks) part. Major inclusion
criteria were hemodialysis for at least 90 days, serum intact parathyroid hormone
(iPTH) ? 300 pg/ml, and serum albumin-corrected Ca (cCa) ? 9.0 mg/dl. There were
3 single-dose cohorts (n = 6 each) randomized 2:1 to 5, 10, or 20 mg
etelcalcetide or placebo, and 2 multiple-dose cohorts (n = 11 each) randomized
8:3 to 2.5 or 5 mg etelcalcetide or placebo. RESULTS: Etelcalcetide plasma
concentration decreased rapidly after i.v. administration, generally remained
stable from 24 hours postdose to the next dialysis, and then decreased by
dialysis. Etelcalcetide exposure increased dose proportionally. Etelcalcetide
plasma predialysis concentration reached almost steady state at week 4. A single
dose of etelcalcetide dose-dependently reduced serum iPTH in 30 minutes, and the
reduction reached a plateau at 1 hour that lasted until 8 hours. The percent
change from baseline serum iPTH thereafter showed a trend to gradually decrease;
it was still -30% or greater on day 3. Similar results were obtained at the last
injection (days 27-29) of the multiple dose. The effect of the multiple dose
was sustained during the interdialytic period. Etelcalcetide decreased serum cCa
in a more gradual but dose-dependent and sustained manner. DISCUSSION:
Etelcalcetide dose-dependently reduced serum iPTH and serum cCa. Moreover, the
effect was sustained in the interdialytic period.