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dc.contributor.authorParfrey, PS
dc.contributor.authorDrüeke, TB
dc.contributor.authorBlock, GA
dc.contributor.authorCorrea-Rotter, R
dc.contributor.authorFloege, J
dc.contributor.authorHerzog, CA
dc.contributor.authorLondon, GM
dc.contributor.authorMahaffey, KW
dc.contributor.authorMoe, SM
dc.contributor.authorWheeler, DC
dc.contributor.authorKubo, Y
dc.contributor.authorDehmel, B
dc.contributor.authorGoodman, WG
dc.contributor.authorChertow, GM
dc.contributor.authorEvaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial Investigators,
dc.date.accessioned2015-07-01T11:43:08Z
dc.date.issued2015-01-01
dc.date.issued2015-01-01
dc.date.issued2015-01-01
dc.date.issued2015-05-07
dc.identifier.urihttp://qmro.qmul.ac.uk/jspui/handle/123456789/7812
dc.descriptionThis article contains supplemental material online at http://cjasn. asnjournals.org/lookup/suppl/doi:10.2215/CJN.07730814/-/ DCSupplemental.en_US
dc.description.abstractBACKGROUND AND OBJECTIVES: The calcimimetic cinacalcet reduced the risk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older (≥65 years, n=1005) and younger (<65 years, n=2878) patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified. RESULTS: Older patients had higher baseline prevalence of diabetes mellitus and CV comorbidity. Annualized rates of kidney transplantation and parathyroidectomy were >3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. CONCLUSIONS: In the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone.
dc.description.sponsorshipThe Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) trial was funded by Amgen.en_US
dc.format.extent791 - 799
dc.languageeng
dc.language.isoenen_US
dc.relation.ispartofClin J Am Soc Nephrol
dc.subjectCKD
dc.subjectcardiovascular disease
dc.subjecthemodialysis
dc.subjecthyperparathyroidism
dc.subjectmineral metabolism
dc.subjectAdult
dc.subjectAge Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectCalcimimetic Agents
dc.subjectCardiovascular Diseases
dc.subjectCinacalcet Hydrochloride
dc.subjectFemale
dc.subjectHumans
dc.subjectHyperparathyroidism, Secondary
dc.subjectKidney Failure, Chronic
dc.subjectKidney Transplantation
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectParathyroidectomy
dc.subjectRenal Dialysis
dc.subjectSeverity of Illness Index
dc.titleThe Effects of Cinacalcet in Older and Younger Patients on Hemodialysis: The Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial.
dc.typeJournal Article
dc.identifier.doi10.2215/CJN.07730814
dc.relation.isPartOfClinical Journal of the American Society of Nephrology
dc.relation.isPartOfClinical Journal of the American Society of Nephrology
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/25710802
pubs.issue5
pubs.organisational-group/Queen Mary University of London
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/William Harvey Research Institute
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/William Harvey Research Institute/Translational Medicine & Therapeutics
pubs.publication-statusPublished
pubs.volume10


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