title: Cinacalcet as alternative treatment for primary hyperparathyroidism: achievements and prospects.
abstract: Primary hyperparathyroidism (pHPT), which most frequently occurs asymptomatically, is a common endocrine disease associated with increased morbidity and mortality. The newly introduced management guidelines as well as the recent availability of the first calcimimetic offer a highly promising therapeutic option for patients with pHPT. Cinacalcet, the first available calcimimetic, increases the sensitivity of the calcium-sensing receptor (CaR) to circulating serum calcium, thereby safely reducing serum calcium and PTH concentrations in patients with mild-to-moderate pHPT, intractable disease, and also parathyroid carcinoma. Cinacalcet has proved efficient in short- and long-term controls of hypercalcemia and, though bone mineral density was not improved, the available data point to cinacalcet as the treatment of choice in non-operable patients with pHPT. These results encompass a wide spectrum of disease severity. Results are pending as to whether cinacalcet decreases mortality and morbidity in pHPT, confirmation of which would conclusively recommend this drug as a valid alternative to surgery.
authors: Endocrine Unit, Evgenidion Hospital, University of Athens, 20 Papadiamantopoulou Str, 11528, Athens, Greece. ledunt@otenet.gr
authors: Leonidas H
authors: LH
authors: Duntas
authors: Nikolaos
authors: N
authors: Stathatos
mesh_terms: D057966:Calcimimetic Agents / Q000627:therapeutic use; D000069449:Cinacalcet; D000075202:Contraindications; D004164:Diphosphonates / Q000627:therapeutic use; D013507:Endocrine Surgical Procedures; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D009281:Naphthalenes / Q000009:adverse effects / Q000627:therapeutic use*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use
chemical_list: D057966:Calcimimetic Agents; D004164:Diphosphonates; D009281:Naphthalenes; D020845:Selective Estrogen Receptor Modulators; D000069449:Cinacalcet