title: Cinacalcet hydrochloride for the treatment of hyperparathyroidism.
abstract: BACKGROUND
  Effective therapeutic strategies are warranted to reduce the burden of parathyroid hormone excess related morbidity and mortality. The calcimimetic agent cinacalcet hydrochloride is a promising treatment strategy in hyperparathyroidism.
  
  
  METHODS
  This review provides an overview of the pharmacokinetics, clinical efficacy, cost-effectiveness, safety and the efficacy profile of cinacalcet in the setting of primary and secondary hyperparathyroidism (p/sHPT). The authors searched PubMed database for English language articles related to cinacalcet in human subjects, published till Dec 2012 - focusing on the period between 2008 and 2012.
  
  
  CONCLUSIONS
  The use of cinacalcet in pHPT can be considered on those hypercalcemic patients in whom parathyroidectomy is not performed. However, data on the impact of cinacalcet on hard clinical outcomes in pHPT are missing. Despite effective improvements of biochemical parameters of sHPT, the intention-to-treat-based analysis of the EVOLVE trial did not support the notion that cinacalcet significantly reduces the risk of death or major cardiovascular events in dialysis patients with moderate-to-severe sHPT. Considering the strong evidence indicating beneficial effects of cinacalcet in the setting of HPT, further randomized controlled trials are definitely warranted to evaluate whether calcimimetic treatment might improve mortality and cardiovascular risk in patients with parathyroid hormone excess over a broad spectrum of kidney function.
authors: Medical University of Graz, Department of Cardiology, Auenbruggerplatz 15, 8036 Graz, Austria.
authors: Nicolas
authors: N
authors: Verheyen
authors: Stefan
authors: S
authors: Pilz
authors: Kathrin
authors: K
authors: Eller
authors: Katharina
authors: K
authors: Kienreich
authors: Astrid
authors: A
authors: Fahrleitner-Pammer
authors: Burkert
authors: B
authors: Pieske
authors: Eberhard
authors: E
authors: Ritz
authors: Andreas
authors: A
authors: Tomaschitz
mesh_terms: D057966:Calcimimetic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D000069449:Cinacalcet; D003362:Cost-Benefit Analysis; D006801:Humans; D006961:Hyperparathyroidism / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology; D009281:Naphthalenes / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D012720:Severity of Illness Index
chemical_list: D057966:Calcimimetic Agents; D009281:Naphthalenes; D010281:Parathyroid Hormone; D000069449:Cinacalcet