| Background:Secondary hyperparathyroidism(SHPT)is an important complication of chronic kidney disease,usually from chronic kidney disease(CKD)3 period blood parathyroid hormone(PTH)levels rise,it can not only cause serious damage to the bone,But also can lead to multiple organs,other than bone damage,caused by metastatic calcification,anemia,skin itching,growth retardation,nervous system damage and cardiovascular disease,seriously affect the patient’s quality of life and survival time are the important risk factors in patients with increased mortality.In recent years,related studies have shown that Etelcalcetide as a new intravenous calcium sensing receptor agonist can effectively reduce serum PTH level without serious side effects.Objective:Weperformed this meta-analysis to evaluate the efficacy and safety of Etelcalcetide in the treatment of secondary hyperparathyroidism in patients with chronic renal failure.Methods:Through the control test database to collect all the relevant Etelcalcetide in the treatment of chronic kidney disease secondary hyperparathyroidism research literature China How Net,China biomedical literature databases,PUBMED,EMBASE,MEDLINE,Cochrane library and then develop into clinical retrieval;and exclusion criteria,then according to the inclusion and exclusion criteria were ultimately included in the literature and the application of Jadad score the standard to evaluate the quality of the included literature;finally from the 5.3 edition of the research into the efficacy and safety of Meta data extraction and analysis of application of Rev Man software in the literature.Result:A total of 5 literatures were included in this system,including 6 studies,with a total of 1976 patients.The Mata analysis results showed that: compared with placebo,after Etelcalcetide treatment,the proportion of patients achieving greater than or equal to 30% reduction from in mean PTH value was significantly higher than that in the placebo group(OR 30.77,95%CI(19.53189.45);P<0.00001);the proportion of patients achieving mean PTH less than or equal to 300pg/ ml was significantly higher than that in the placebo group(OR 23.63,95%CI(15.47,36.11);P<0.00001).Moreover,the Etelcalcetide group had lower phosphorus level(SMD-1.12,95%CI(-1.99,-0.26),P=0.01),lower calcium level(SMD-4.11,95%CI(-8.00,-0.21)),lower level of FGF23.The common side effects of blood calcium decrease,nausea and vomiting,paresthesia,hypocalcemia have higher incidence,the incidence was no significant difference in headache,limb pain,hypotension,serious adverse reactions related to the drug were not found in the study.Compared with the positive control drug,Cinacalcet,only one study was unable to carry out Mate analysis.Block 2017 results showed that the proportion of PTH dropped more than 30% was 57.7%(198 of 343)in the Cinacalcet group,and 68.2%(232 of 340)in Etelcalcetide group.The difference was statistically significant,and the most common side effect was the decrease of blood calcium(59.8% vs 68.9%).Conclusion:Etelcalcetide can reduce serum PTH level and reduce blood phosphorus,calcium and FGF-23 without serious side effects.It is a new intravenous calcium sensitive receptor agonist. |
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