The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone
Background: Cinacalcet is a calcimimetic drug that has increasingly been used as a bridging therapy for primary hyperparathyroidism (pHPT), especially during the COVID-19 pandemic. The aim of our study was to investigate if preoperative cinacalcet therapy affects intraoperative parathyroid hormone (...
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MDPI AG
2022-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/7/2015 |
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| author | Olga Radulova-Mauersberger Julia Keßler Ulrich Keßler Katrin Stange Sandra Korn Jürgen Weitz Ulrich Bork |
| author_facet | Olga Radulova-Mauersberger Julia Keßler Ulrich Keßler Katrin Stange Sandra Korn Jürgen Weitz Ulrich Bork |
| author_sort | Olga Radulova-Mauersberger |
| collection | DOAJ |
| description | Background: Cinacalcet is a calcimimetic drug that has increasingly been used as a bridging therapy for primary hyperparathyroidism (pHPT), especially during the COVID-19 pandemic. The aim of our study was to investigate if preoperative cinacalcet therapy affects intraoperative parathyroid hormone (IOPTH) monitoring during parathyroidectomy, which is an important indicator for the success of surgery. Methods: In this single-center retrospective analysis, we studied the outcomes of 72 patients who underwent surgery for pHPT. We evaluated two groups: those with cinacalcet therapy before operation—the cinacalcet group (CG)—and those without medical therapy preoperatively (non-CG). In order to perform a between-group comparison of time trends, we fit a linear mixed-effects model with PTH as the response variable and predictors PTH levels preoperatively, group (cinacalcet yes/no), time, the group-by-time interaction, and a random intercept (per subject). Results: Our cohort included 51 (71%) women and 21 (29%) men, who were operated upon for pHPT in the period from January 2018 until August 2021. All patients were diagnosed with pHPT and 54% of the cohort were symptomatic for hypercalcemia. Moreover, 30% of the patients were treated with cinacalcet as a bridging therapy preoperatively, and this increased during the COVID-19 pandemic, as 64% of this group were treated in the last two years. Calcium values were significantly different before (<i>p</i> < 0.001) and after (<i>p</i> = 0.0089) surgery, but calcium level change did not differ significantly between the CG and non-CG. Parathyroid hormone (PTH) levels dropped significantly in both groups during 10 min IOPTH monitoring (<i>p</i> < 0.001), but there was no significant difference between the two groups (<i>p</i> = 0.212). Conclusions: In the examined patient cohort, the use of cinacalcet did not affect the value of IOPTH monitoring during surgery for pHPT. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T11:42:44Z |
| publishDate | 2022-04-01 |
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| spelling | doaj.art-a574545a53654235a2ec3903adc34f2d2023-11-30T23:30:04ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01117201510.3390/jcm11072015The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid HormoneOlga Radulova-Mauersberger0Julia Keßler1Ulrich Keßler2Katrin Stange3Sandra Korn4Jürgen Weitz5Ulrich Bork6Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, GermanyDepartments of Surgery and Endocrinology, Oberlausitz-Kliniken gGmbH and MVZ, 02625 Bautzen, GermanyDepartments of Surgery and Endocrinology, Oberlausitz-Kliniken gGmbH and MVZ, 02625 Bautzen, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, GermanyBackground: Cinacalcet is a calcimimetic drug that has increasingly been used as a bridging therapy for primary hyperparathyroidism (pHPT), especially during the COVID-19 pandemic. The aim of our study was to investigate if preoperative cinacalcet therapy affects intraoperative parathyroid hormone (IOPTH) monitoring during parathyroidectomy, which is an important indicator for the success of surgery. Methods: In this single-center retrospective analysis, we studied the outcomes of 72 patients who underwent surgery for pHPT. We evaluated two groups: those with cinacalcet therapy before operation—the cinacalcet group (CG)—and those without medical therapy preoperatively (non-CG). In order to perform a between-group comparison of time trends, we fit a linear mixed-effects model with PTH as the response variable and predictors PTH levels preoperatively, group (cinacalcet yes/no), time, the group-by-time interaction, and a random intercept (per subject). Results: Our cohort included 51 (71%) women and 21 (29%) men, who were operated upon for pHPT in the period from January 2018 until August 2021. All patients were diagnosed with pHPT and 54% of the cohort were symptomatic for hypercalcemia. Moreover, 30% of the patients were treated with cinacalcet as a bridging therapy preoperatively, and this increased during the COVID-19 pandemic, as 64% of this group were treated in the last two years. Calcium values were significantly different before (<i>p</i> < 0.001) and after (<i>p</i> = 0.0089) surgery, but calcium level change did not differ significantly between the CG and non-CG. Parathyroid hormone (PTH) levels dropped significantly in both groups during 10 min IOPTH monitoring (<i>p</i> < 0.001), but there was no significant difference between the two groups (<i>p</i> = 0.212). Conclusions: In the examined patient cohort, the use of cinacalcet did not affect the value of IOPTH monitoring during surgery for pHPT.https://www.mdpi.com/2077-0383/11/7/2015parathyroidectomypHPTPTHCOVID-19hypercalcemiacalcimimetic |
| spellingShingle | Olga Radulova-Mauersberger Julia Keßler Ulrich Keßler Katrin Stange Sandra Korn Jürgen Weitz Ulrich Bork The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone Journal of Clinical Medicine parathyroidectomy pHPT PTH COVID-19 hypercalcemia calcimimetic |
| title | The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone |
| title_full | The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone |
| title_fullStr | The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone |
| title_full_unstemmed | The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone |
| title_short | The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in Parathyroid Hormone |
| title_sort | effect of the frequently used cinacalcet for phpt during the covid 19 pandemic on perioperative decrease in parathyroid hormone |
| topic | parathyroidectomy pHPT PTH COVID-19 hypercalcemia calcimimetic |
| url | https://www.mdpi.com/2077-0383/11/7/2015 |
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