A Bayesian network analysis on comparative efficacy of treatment strategies for dialysis patients with secondary hyperparathyroidism

  • Authors:
    • Huizhen Ye
    • Peiyi Ye
    • Zhe Zhang
    • Aizhen Hou
    • Zijie Liang
    • Yaozhong Kong
  • View Affiliations

  • Published online on: October 31, 2018     https://doi.org/10.3892/etm.2018.6906
  • Pages: 531-540
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Abstract

For dialysis patients with end‑stage kidney disease and secondary hyperparathyroidism (SHPT), there are three therapeutic treatment options: Cinacalcet, paricalcitol and cinacalcet plus low‑dose vitamin D analogues. However, their comparative efficacy remains unclear at present. Thus, in the current study, a Bayesian network analysis was conducted to evaluate the relative efficacy and safety of these three therapeutic regimens. A comprehensive literature database query was performed. The primary outcome was the treatment effect on serum parathyroid hormone (PTH) levels. Secondary outcomes included the occurrence of nausea and hypocalcaemia. A total of 20 randomized clinical trials, including 5,390 dialysis patients, were entered into the analysis. Paricalcitol, cinacalcet plus vitamin D analogue and cinacalcet were significantly more efficacious in controlling PTH levels compared with conventional therapy (which comprises calcium‑based phosphate binders, non‑calcium‑based phosphate binders and vitamin D analogues) [odds ratio (OR)=3.99, 2.91 and 2.47, respectively] and placebo (OR=20.32, 14.89 and 12.56, respectively). Paricalcitol was identified as the most efficacious of the three treatments. According to a ranking analysis, patients treated with cinacalcet had a higher possibility of frequently developing nausea and hypocalcaemia compared with patients treated with cinacalcet plus low‑dose active vitamin D analogues. All three therapeutic treatment options were efficacious for the treatment of dialysis patients with SHPT in controlling PTH levels. Paricalcitol had the highest possibility of being the most optimal one. Thus, paricalcitol therapy may be the most optimal regimen in controlling PTH levels, but this should be confirmed by further study.
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January-2019
Volume 17 Issue 1

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Ye H, Ye P, Zhang Z, Hou A, Liang Z and Kong Y: A Bayesian network analysis on comparative efficacy of treatment strategies for dialysis patients with secondary hyperparathyroidism. Exp Ther Med 17: 531-540, 2019
APA
Ye, H., Ye, P., Zhang, Z., Hou, A., Liang, Z., & Kong, Y. (2019). A Bayesian network analysis on comparative efficacy of treatment strategies for dialysis patients with secondary hyperparathyroidism. Experimental and Therapeutic Medicine, 17, 531-540. https://doi.org/10.3892/etm.2018.6906
MLA
Ye, H., Ye, P., Zhang, Z., Hou, A., Liang, Z., Kong, Y."A Bayesian network analysis on comparative efficacy of treatment strategies for dialysis patients with secondary hyperparathyroidism". Experimental and Therapeutic Medicine 17.1 (2019): 531-540.
Chicago
Ye, H., Ye, P., Zhang, Z., Hou, A., Liang, Z., Kong, Y."A Bayesian network analysis on comparative efficacy of treatment strategies for dialysis patients with secondary hyperparathyroidism". Experimental and Therapeutic Medicine 17, no. 1 (2019): 531-540. https://doi.org/10.3892/etm.2018.6906