P1426EFFECTIVENESS AND SAFETY OF ETELCALCETIDE IN THE LONG TERM IN CLINICAL PRACTICE IN HEMODIALYSIS PATIENTS WITH SECONDARY HYPERPARATHYROIDISM

Abstract Background and Aims : Secondary hyperparathyroidism (HPT) is a frequent complication in hemodialysis (HD) patients. Until now we had oral Vit / D analogues and oral Cinacalcet for treatment. The appearance of Etelcalcetide brings new treatment possibilities. Apart from clinical trials there are few long-term results in usual practice. Our goal is to evaluate results with the use of Etelcalcetide after more than a year of treatment in clinical practice of HD. Method We carry out a prospective descriptive study for 15 months with patients with HPT-HD, the ones who were with Cinacalcet and had not responded or had intolerance were changed to Etelcalcetide. Patients without prior treatment with calcimimetics were also included. Treatment with Vit D analogues and phosphate binders is treated according to usual clinical practice. Results We studied 25 HD patients, 12 men and 13 women with a mean age of 59.5 ± 13.6 years, 11 began de novo calcimimetic treatment and in 14 Cinacalcet was modified to Etelcalcetide due to lack of response or poor oral tolerance. Starting dose 2.5 mg post-dialysis, mean final dose 7.5 mg. We observed a reduction of PTH ≥30% in 80% of patients and a decrease ≥50% in 52%, Figure 1 shows the decrease over 15 months. The calcium corrected to albumine (Cac) decreased 4.8% ± 8 compared to baseline. The majority of patients present mild hypocalcemia (Cac between 7.5 and 8.3 mg / dl) and asymptomatic. There are no differences with P. Patients with PTH in range according to KDIGO went from 8% to 63%. No serious clinical manifestations of hypocalcemia or symptoms of digestive intolerance or other side effects appeared.  Conclusion Etelcalcetide in the long term significantly improves the control of HPT in HD with a high safety profile. IV administration facilitates compliance without having followed serious side effects in 15 months of follow-up.