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Effectiveness of calcimimetics on fractures in dialysis patients with secondary hyperparathyroidism: meta-analysis of randomized trials

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Abstract

Introduction

This study aimed to assess the effectiveness of calcimimetics in reducing the risk of fractures in dialysis patients with secondary hyperparathyroidism (SHPT).

Material and methods

A comprehensive literature search was conducted using PubMed, Embase, and Cochrane Library for articles published through December 9, 2023. The quality of each trial was evaluated using the Cochrane Collaboration tool. Meta-analysis was performed using a random-effects model, and effect measures across studies were synthesized. The risk ratio (RR) and 95% confidence interval (CI) were used to quantify the risk of fracture.

Results

We identified seven studies involving 6481 dialysis patients with SHPT. The administration of calcimimetics reduced fracture incidence compared to placebo or conventional treatment (RR: 0.50, 95% CI 0.29–0.88, p = 0.02). Calcimimetics demonstrated a low number needed to treat (NNT) to prevent an incident fracture (NNT: 47).

Conclusion

The use of calcimimetics offers a significant benefit in reducing the risk of fractures in patients undergoing dialysis with SHPT.

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Author information

Authors and Affiliations

  1. Department of Nephrology and Rheumatology, Niigata City General Hospital, Niigata, Japan

    Takuya Wakamatsu

  2. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan

    Suguru Yamamoto

  3. Division of Nephrology, Niigata Shirone General Hospital, Niigata, Japan

    Koji Matsuo

  4. Fukuoka Renal Clinic, Fukuoka, Japan

    Masatomo Taniguchi

  5. Department of Nephrology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan

    Takayuki Hamano

  6. Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Takayuki Hamano

  7. Division of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan

    Masafumi Fukagawa

  8. Division of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan

    Junichiro James Kazama

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  1. Takuya Wakamatsu
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  2. Suguru Yamamoto
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  4. Masatomo Taniguchi
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  5. Takayuki Hamano
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  6. Masafumi Fukagawa
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  7. Junichiro James Kazama
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Contributions

Conception, study design, and interpretation of the data were performed by T.W., S.Y., K.M., M.T., T.H., M.F. and J.K. Systematic reviews were performed by T.W., S.Y., and K.M. Meta-analyses were performed by T.W. and S.Y. The manuscript was drafted by T. W. and S. Y. Approval of the final version of the manuscript was provided by T. W., S. Y., K. M., M. T., T. H., M.F., and J. K.

Corresponding author

Correspondence to Suguru Yamamoto.

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Conflict of interest

S.Y. has received honoraria from Kyowa Kirin, and research findings from Toray Medical Co., Ltd and Kaneka Medix Co., Ltd. M.T. received honoraria from Kyowa Kirin, Bayer Yakuhin Ltd., Mitsubishi Tanabe Pharma Corporation, Kissey Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Torii Pharmaceutical Co., Ltd.,and Daiichi Sankyo Company Ltd. T.H. has received honoraria, consulting fees, and grant support from Kissei Pharmaceutical, Kyowa Hakko Kirin, Ono Pharmaceutical, and Sanwa Kagaku Kenkyusho. M.F. has received honoraria, consulting fees, and/or grant support from Kyowa Kirin, Ono Pharmaceutical, Sanwa Kagaku Kenkyusho, and Kissei Pharmaceutical. The other authors declare no conflicts of interest. J.K. has received honoraria from Kyowa Kirin.

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This article is a meta-analysis and does not contain any studies with human participants performed by the authors.

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Wakamatsu, T., Yamamoto, S., Matsuo, K. et al. Effectiveness of calcimimetics on fractures in dialysis patients with secondary hyperparathyroidism: meta-analysis of randomized trials. J Bone Miner Metab (2024). https://doi.org/10.1007/s00774-024-01500-y

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