Table 3.
MBD Marker Outcomes in US HD Facilities That Switched to Etelcalcetide-First Versus Remained Cinacalcet-First: Approach 2 Results.
| Switched to Etelcalcetide-first | Remained Cinacalcet-first | Adjusted Diff-in-diff (95% CI) | P | |||
|---|---|---|---|---|---|---|
| Period 1 | Period 2 | Period 1 | Period 2 | |||
| N facilities | 32 | 32 | 34 | 34 | -- | -- |
| N calcimimetic users | 612 | 793 | 536 | 673 | -- | -- |
| Continuous outcomes | ||||||
| PTH (pg/mL) | 671 ± 580 | 484 ± 379 | 632 ± 463 | 698 ± 534 | −169 (−249, −90) | <0.001 |
| Serum Ca (mg/dL) | 9.1 ± 0.6 | 8.9 ± 0.6 | 9.1 ± 0.5 | 9.0 ± 0.6 | −0.10 (−0.20, −0.01) | 0.04 |
| Serum P (mg/dL) | 5.5 ± 1.3 | 5.5 ± 1.4 | 5.6 ± 1.4 | 5.8 ± 1.5 | 0.04 (−0.17, 0.25) | 0.71 |
| Binary outcomes | ||||||
| PTH >600 pg/mL | 39% | 21% | 37% | 43% | −14.4% (−22.0, −6.8) | <0.001 |
| Ca <8.4 mg/dL | 12% | 19% | 10% | 13% | 5.5% (−0.2, 11.3) | 0.06 |
| P >5.5 mg/dL | 48% | 46% | 48% | 53% | −1.9% (−9.6, 5.8) | 0.62 |
Note: Results shown as crude mean ± standard deviation and prevalence (%) in period 1 and period 2 columns; Linear mixed models with random facility intercept adjusted for HD facility characteristics (dialysis organization size, facility size, facility % Black race, hospital-based, facility % total calcimimetic use) and patient characteristics (age, sex, Black race, dialysis vintage, body mass index, serum albumin, hemoglobin, serum potassium, 13 summary comorbid conditions, catheter use); Adjusted diff-in-diff (95% CI) parameter derived from the interaction effect between period and facility calcimimetic preference. Abbreviations: Ca, calcium; CI, confidence interval; HD, hemodialysis; P, phosphorus; PTH, parathyroid hormone; Outcomes in period 1 assessed November 2016-April 2017; outcomes in period 2 assessed September 2019-February 2020. After implementing inclusion criteria requiring PTH data, >99% of patients also had data on serum calcium and serum phosphorus.