SP681NICE GUIDELINES FOR THE PRESCRIPTION OF CINACALCET IN HAEMODIALYSIS PATIENTS; A DISTRICT GENERAL HOSPITAL'S EXPERIENCE

Ben Oliveira, Steve Maclaren, Manisha Notay, Georgia Winnett
2015 Nephrology, Dialysis and Transplantation  
Introduction and Aims: Secondary hyperparathyroidism is a source of significant morbidity for haemodialysis patients. NICE guidelines recommend cinacalcet for those who have high levels of parathyroid despite standard treatments and are not suitable for a parathyroidectomy. While effective at reducing parathyroid hormone levels, cinacalcet treatment is expensive and a recent multi-centre trial has not shown a mortality benefit with its use. In light of the results from the EVOLVE study we set
more » ... OLVE study we set out to analyse the adherence to NICE guidelines and their suitability and relevance to haemodialysis patients in a U.K. setting. Methods: This was a retrospective data analysis of all haemodialysis patients at Basildon Hospital who were on cinacalcet therapy at any time from 01/11/2012 to 31/ 10/2013. We analysed all PTH, calcium, and phophate levels that were taken from the initiation of their cinacalcet therapy until their cessation, parathyroidectomy, or the chronological end point of our dataset. Our data was analysed in the context of NICE's stipulations for initiation and continuation of therapy [PTH levels should be > 85pmol/ L and show a 30% reduction at 4 months]. Expenditure on cinacalcet was calculated, and compared to expenditure if NICE guidance was rigidly followed. Results: BTUH has 177 patients on haemodialysis, 176 of whom have secondary
doi:10.1093/ndt/gfv199.47 fatcat:kgnehv4nrbdlvk7zmmbcv4uri4