The Effect of the Frequently Used Cinacalcet for pHPT during the COVID-19 Pandemic on Perioperative Decrease in...

Area of Science:

• Endocrinology
• Surgical Oncology
• Pharmacology

Background:

• Cinacalcet, a calcimimetic, is increasingly used for primary hyperparathyroidism (pHPT) bridging therapy, particularly during the COVID-19 pandemic.
• Intraoperative parathyroid hormone (IOPTH) monitoring is a key indicator of surgical success in parathyroidectomy.
• The impact of preoperative cinacalcet on IOPTH monitoring requires investigation.

Purpose of the Study:

• To determine if preoperative cinacalcet therapy influences intraoperative parathyroid hormone (IOPTH) monitoring during parathyroidectomy for pHPT.
• To assess the reliability of IOPTH monitoring in patients treated with cinacalcet versus those not treated.

Main Methods:

• A single-center retrospective analysis of 72 patients undergoing parathyroidectomy for pHPT.
• Patients were divided into two groups: cinacalcet group (CG) and non-cinacalcet group (non-CG).
• Linear mixed-effects models were used to compare time trends in parathyroid hormone (PTH) levels between groups.

Main Results:

• No significant difference in calcium level changes between the CG and non-CG post-surgery.
• Parathyroid hormone (PTH) levels dropped significantly in both groups during 10-minute IOPTH monitoring.
• There was no statistically significant difference in PTH level changes between the cinacalcet and non-cinacalcet groups (p = 0.212).

Conclusions:

• Preoperative cinacalcet therapy does not appear to affect the reliability of intraoperative parathyroid hormone monitoring during parathyroidectomy for pHPT.
• IOPTH monitoring remains a valuable tool for assessing surgical success in pHPT patients, regardless of preoperative cinacalcet use.