Drug Insight: renal indications of calcimimetics.
Calcimimetics suppress the secretion of parathyroid hormone by sensitizing the parathyroid calcium receptor to serum calcium. Cinacalcet (Sensipar/Mimpara), Amgen Inc., Thousand Oaks, CA), the first-in-class calcimimetic agent approved for treatment of secondary hyperparathyroidism in dialysis patients, is, in association with higher dose of a calcium-based oral phosphate binder, a well-tolerated and effective alternative to standard treatments such as vitamin D derivatives in association with a non-calcium-based oral phosphate binder. Here, we present an overview of evidence in support of this assertion. We extend our discussion to encompass other indications for calcimimetics -- secondary hyperparathyroidism in predialysis chronic kidney disease patients, hypercalcemic hyperparathyroidism in renal transplant recipients, primary hyperparathyroidism, and hypercalcemia associated with parathyroid carcinoma -- as well as providing guidance on optimal usage of this drug.
Shahapuni
Irina
I
Department of Nephrology Internal Medicine, Amiens University Hospital, Jules Verne University of Picardy, France.
Monge
Matthieu
M
Oprisiu
Roxana
R
Mazouz
Hakim
H
Westeel
Pierre-François
PF
Morinière
Philippe
P
Massy
Ziad
Z
Choukroun
Gabriel
G
Fournier
Albert
A
D002118:Calcium / Q000097:blood; D000069449:Cinacalcet; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D009281:Naphthalenes / Q000494:pharmacology*; D010282:Parathyroid Neoplasms / Q000097:blood / Q000150:complications; D006435:Renal Dialysis
D009281:Naphthalenes; D002118:Calcium; D000069449:Cinacalcet