Routine cinacalcet for end stage kidney disease not warranted

Cinacalcet, a drug commonly given to patients with end stage kidney disease to help keep phosphorus and parathyroid blood levels within a target range and has few patient level clinical benefits and several adverse effects, suggesting that it should no longer be routinely prescribed, according to a study by international researchers published in this week's PLOS Medicine (US Public Library of Science).

These findings are important as cinacalcet has become the largest single drug cost for patients on dialysis in the US, with an annual expenditure of at least US $260 million. In the UK, prescribing costs for this drug increased by up to 33% from 2010 to 2011, with no improvement in the survival of these patients. Cinacalcet is the active ingredient of leading independent biotech firm Amgen’s (Nasdaq: AMGN) Sensipar/Mimpara, which generated first quarter 2013 sales of $264 million.

In an analysis led by Giovanni Strippoli, an academic at the University of Sydney in Australia and a senior medical and research executive at Diaverum (a provider of renal services), the researchers examined the clinical effects of cinacalcet in almost 7500 patients by combining the findings from previous randomized controlled trials.