Effect of vitamin D receptor activators on cardiovascular events in patients on hemodialysis—A post hoc analysis of the LANDMARK study
Abstract
Introduction
The clinical benefit of vitamin D receptor activators (VDRA) in patients with well-controlled secondary hyperparathyroidism undergoing dialysis remains unclear.
Methods
This post hoc analysis of the LANDMARK study investigates if VDRA use is associated with cardiovascular benefits. Data of 2135 patients undergoing hemodialysis who were at risk for vascular calcification were analyzed using a Cox proportional hazards model with propensity-score matching.
Results
The hazard ratio (HR) for VDRA use was 0.99 (95% confidence interval [CI]: 0.67–1.46; p = 0.945) for cardiovascular events and 0.89 (95% CI: 0.62–1.28; p = 0.541) for all-cause mortality at baseline. Among patients who always used VDRA, the HR was 1.12 (95% CI: 0.67–1.89; p = 0.666) for cardiovascular events and 1.11 (95% CI: 0.67–1.85; p = 0.688) for all-cause mortality compared to those who never used VDRA.
Conclusion
The use of VDRA does not reduce the risks of cardiovascular events or all-cause mortality in patients on dialysis with well-controlled secondary hyperparathyroidism.
CONFLICT OF INTEREST
Takuya Mizukami receives consultancy fees from Zeon Medical Inc.; research grants from Boston Scientific; and speaker fees from Abbott Vascular, Cathworks, and Boston Scientific. Masafumi Fukagawa receives lecture fees from Bayer Yakuhin, Kyowa Kirin, Kissei, Ono Pharmaceutical, and Sanwa Kagaku and grants from Kyowa Kirin, Chugai, and Torii. Tadao Akizawa receives consulting and lecture fees from Bayer Yakuhin, Astellas, Kyowa Kirin, Kissei Pharmaceutical, Ono Pharmaceutical, Fuso Pharmaceutical Industry, and Torii Pharmaceutical; consulting fees from GlaxoSmithKline, JT Pharmaceutical, Nipro Corporation, Otsuka, and Sanwa Kagaku; and lecture fees from Chugai Pharmaceutical and Mitsubishi Tanabe Pharma. Hiroaki Ogata receives lecture fees from Bayer Yakuhin, Kyowa Kirin, Torii Pharmaceutical, Otsuka, Kissei Pharmaceutical, Mitsubishi Tanabe Pharma, Sumitomo Dainippon Pharm, Daiichi Sankyo, Kowa, and Ono Pharmaceutical; grants from Torii Pharmaceutical and Ono Pharmaceutical; and consulting fees from YL Biologics. Naoki Uchida receives consultancy fees from TOA EIYO, Meiji seika pharma, AstraZeneca, Daiichi Sankyo Company Ltd, Eisai Co., Ltd, Sanwa kagaku kenkyusho Co., Ltd, Kyorin Pharmaceutical Co., Ltd., Sanofi K.K., NapaJen Pharma, GC Showayakuhin Corporation, Ito Life Science, Takata Pharmaceutical Co., Ltd., and SSP Co., Ltd. and lecture fees from TOA EIYO, Meiji seika pharma, AstraZeneca, Daiichi Sankyo Company Ltd, and NapaJen Pharma. No other disclosures were reported.
Open Research
DATA AVAILABILITY STATEMENT
The data underlying this article will be shared upon reasonable request to the corresponding author.
