If approved, etelcalcetide will be the first
calcimimetic agent that can be administered intravenously.
Parathyroidectomy may now be necessary or expensive
calcimimetic drugs must be administered to try to restore the disordered metabolic environment.
In many patients with moderate to severe sHPT, cinacalcet, an oral-only
calcimimetic agent, is also required, and for some, surgical therapy (typically subtotal parathyroidectomy [PTX]) may be necessary (National Kidney Foundation 2003).
Effects of the
calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and healthrelated quality of life in secondary hyperparathyroidism.
Elevated iPTH levels caused by secondary hyperparathyroidism in chronic kidney disease patients are generally treated with either a vitamin D receptor activator like Zemplar or a
calcimimetic like cinacalcet, or additionally, may be treated with the combination of a vitamin D receptor activator plus a
calcimimetic.
Cinacalcet is a
calcimimetic drug, which lowers PTH without increasing calcium or phosphorus.
This finding diametrically changes the treatment strategy to controlling the effects of CKD on the cardiovascular system by decreasing the serum phosphorus and on the PTH concentration by using a
calcimimetic agent, because the presence of hypercalcemia contraindicates increasing the dose of vitamin D analogs.
Calcimimetic agents: Calcium is not a unique ligand for the CaR, although it is the only one with a convincing physiological role.
Cinacalcet is a type II
calcimimetic agent with a novel mechanism of action (7, 11).
The company also announced that its first-in-class oral
calcimimetic, Mimpara, known as Sensipar in the US, has received regulatory approval in the European Union (EU).
Mittman and his colleagues found that as cinacalcet bonded to the calcium receptors,
calcimimetic compound was able to regulate parathyroid hormone (PTH) secretion, he reported in a poster at a meeting on clinical nephrology sponsored by the National Kidney Foundation.
Sensipar is an innovative, first-in-class oral
calcimimetic indicated for the treatment of secondary HPT in CKD patients on dialysis, and for the treatment of elevated calcium levels (hypercalcemia) in patients with parathyroid carcinoma.