study to assess patient management practices and quality of life with paricalcitol capsules in the treatment of secondary hyperparathyroidism in stage 3-5 chronic kidney disease patients not yet on dialysis

Conditions: Secondary Hyperparathyroidism; Chronic Kidney Disease

Summary: paricalcitol capsules (zemplar®) received marketing authorization in sweden in late 2007 for the prevention and treatment of secondary hyperparathyroidism in patients with stage 3 \& 4 chronic kidney disease (ckd). accordingly, additional data is needed to evaluate the effectiveness and safety of paricalcitol therapy under conditions of usual clinical care in sweden. this observational study is designed to collect data to evaluate safety and effectiveness during 6 months of therapy with paricalcitol capsules prescribed for patients with ckd stages 3-5 not yet on dialysis. data will also be collected on patient quality of life and costs associated with patient care.

this observational study is designed to collect data to evaluate safety and effectiveness during 6 months of therapy with paricalcitol capsules prescribed in accordance with the terms of the marketing authorization for patients with chronic kidney disease (ckd) stages 3-5 not yet on dialysis. data will also be collected on patient quality of life and costs associated with patient care. a retrospective chart review of patient laboratory and medication history will provide historical data to determine drivers for initiation of paricalcitol therapy. the primary goal of this post-marketing observational study (pmos) is to further characterize the prescribing habits and patient management practices of physicians prescribing paricalcitol capsules and to assess the metabolic safety and effectiveness of paricalcitol capsules for the treatment of secondary hyperparathyroidism in stage 3-5 ckd patients not yet on dialysis under conditions of usual clinical care. focus will be to examine the practice of dose titration in early stages of ckd, understand real-world management of intact parathyroid hormone levels, understand real-world incidence and management of abnormalities in serum calcium and phosphate, and to examine patient bone and mineral profiles and medical history to understand drivers for paricalcitol capsules use. patients prescribed paricalcitol therapy for the first time will be asked to participate in the study. enrolled patients will be followed for 6 months.

Eligibility criteria:
inclusion criteria: patients must sign the informed consent form prior to inclusion into the study * patients should satisfy the swedish summary of product characteristics (spc) for paricalcitol capsules at www.fass.se * patients must be 18 years or older with a diagnosis of secondary hyperparathyroidism associated with chronic kidney disease (ckd) stages 3 - 5 (estimated glomerular filtration rate between 10-59 by modification of diet in renal disease) but not yet on dialysis * patients should be in stable condition and have a life expectancy of at least 6 months * patients should not be expected to be transplanted or initiate dialysis for at least 6 months exclusion criteria: * patients with ckd receiving dialysis * patients contraindicated for paricalcitol capsules as described in the spc * treatment with paricalcitol more than 20 days prior to study enrollment * history of drug or alcohol abuse within 6 months prior to inclusion * history of non-compliance with medication or a medical history (i.e. psychiatric) that could enhance non-compliance with medication as determined by the investigator

Keywords: secondary hyperparathyroidism mineral and bone disorder (ckd-mbd) chronic kidney disease