Your browser doesn't support javascript.
loading
New calcimimetics for secondary hyperparathyroidism in CKD G5D: do they offer advantages?
Negri, Armando L; Bover, Jordi; Vervloet, Marc; Cozzolino, Mario.
Afiliação
  • Negri AL; Nephrology Section, Instituto de Investigaciones Metabólicas, Universidad del Salvador, Libertad 836 1 Floor, Buenos Aires, Argentina. armando.negri@gmail.com.
  • Bover J; Department of Nephrology, University Hospital Germans Trias i Pujol, Badalona, Spain.
  • Vervloet M; Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Cozzolino M; Renal Division, Department of Health Sciences, University of Milan, Milan, Italy.
J Nephrol ; 2024 Oct 15.
Article em En | MEDLINE | ID: mdl-39404956
ABSTRACT
Secondary hyperparathyroidism is one of the most frequent metabolic abnormalities found in patients with chronic kidney disease. The calcium-sensing receptor senses extracellular calcium and is the principal regulator of parathyroid hormone secretion. Cloning of the calcium-sensing receptor led to the development of calcimimetics, drugs that decrease parathyroid hormone secretion through the positive allosteric modulation of this receptor. Cinacalcet was the first oral calcimimetic approved by the US Food and Drug Administration (FDA) in 2004 for the treatment of secondary hyperparathyroidism in adult patients on dialysis. Although cinacalcet has demonstrated safety and effectiveness, it has two main problems gastrointestinal side effects that result in poor adherence, and the inhibitory action on CYP2D6 with the possibility of interactions with commonly used medications. To address the problem of oral compliance, Etelcalcetide, a small synthetic polycationic peptide IV calcimimetic was introduced in 2017. This drug showed a 10% greater decrease in serum parathyroid hormone values compared to cinacalcet but no better gastrointestinal tolerance, with greater risk of hypocalcemia. Several structural modifications were introduced in cinacalcet to produce a new compound called evocalcet. This drug, which was introduced in Japan in 2018, has considerably enhanced bioavailability and decreased both the inhibitory effect on CYP2D6 and half of the gastrointestinal side effects of cinacalcet. Finally, a novel non-peptidic injectable calcimimetic agent, upacicalcet, became available in Japan in 2021. This agent has greater clearance by hemodialysis and shows no effect on gastric emptying. More studies are needed comparing the old calcimimetics to the new ones to establish their future role in the treatment of secondary hyperparathyroidism in chronic kidney disease (CKD) G5D.
Palavras-chave
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Argentina País de publicação: Itália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Argentina País de publicação: Itália