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Role of etelcalcetide in the management of secondary hyperparathyroidism in hemodialysis patients: a review on current data and place in therapy.
Drug Des Devel Ther. 2018; 12:1589-1598.DD

Abstract

Secondary hyperparathyroidism (sHPT) is a frequently occurring severe complication of advanced kidney disease. Its clinical consequences include extraskeletal vascular and valvular calcifications, changes in bone metabolism resulting in renal osteodystrophy, and an increased risk of cardiovascular morbidity and mortality. Calcimimetics are a cornerstone of parathyroid hormone (PTH)-lowering therapy, as confirmed by the recently updated 2017 Kidney Disease: Improving Global Outcomes chronic kidney disease - mineral and bone disorder clinical practice guidelines. Contrary to calcitriol or other vitamin D-receptor activators, calcimimetics reduce PTH without increasing serum-calcium, phosphorus, or FGF23 levels. Etelcalcetide is a new second-generation calcimimetic that has been approved for the treatment of sHPT in adult hemodialysis patients. Whereas the first-generation calcimimetic cinacalcet is taken orally once daily, etelcalcetide is given intravenously thrice weekly at the end of the hemodialysis session. Apart from improving drug adherence, etelcalcetide has proven to be more effective in lowering PTH when compared to cinacalcet, with an acceptable and comparable safety profile. The hope for better gastrointestinal tolerance with intravenous administration did not come true, as etelcalcetide did not significantly mitigate the adverse gastrointestinal effects associated with cinacalcet. Enhanced adherence and strong reductions in PTH, phosphorus, and FGF23 could set the stage for a future large randomized controlled trial to demonstrate that improved biochemical control of mineral metabolism with etelcalcetide in hemodialysis patients translates into cardiovascular and survival benefits and better health-related quality of life.

Authors+Show Affiliations

Department of Internal Medicine, Clinical Division of Nephrology, Medical University of Graz, Graz.Department of Internal Medicine III, Nephrology and Dialysis, Feldkirch Academic Teaching Hospital, Feldkirch, Austria.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29910605

Citation

Friedl, Claudia, and Emanuel Zitt. "Role of Etelcalcetide in the Management of Secondary Hyperparathyroidism in Hemodialysis Patients: a Review On Current Data and Place in Therapy." Drug Design, Development and Therapy, vol. 12, 2018, pp. 1589-1598.
Friedl C, Zitt E. Role of etelcalcetide in the management of secondary hyperparathyroidism in hemodialysis patients: a review on current data and place in therapy. Drug Des Devel Ther. 2018;12:1589-1598.
Friedl, C., & Zitt, E. (2018). Role of etelcalcetide in the management of secondary hyperparathyroidism in hemodialysis patients: a review on current data and place in therapy. Drug Design, Development and Therapy, 12, 1589-1598. https://doi.org/10.2147/DDDT.S134103
Friedl C, Zitt E. Role of Etelcalcetide in the Management of Secondary Hyperparathyroidism in Hemodialysis Patients: a Review On Current Data and Place in Therapy. Drug Des Devel Ther. 2018;12:1589-1598. PubMed PMID: 29910605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of etelcalcetide in the management of secondary hyperparathyroidism in hemodialysis patients: a review on current data and place in therapy. AU - Friedl,Claudia, AU - Zitt,Emanuel, Y1 - 2018/06/01/ PY - 2018/6/19/entrez PY - 2018/6/19/pubmed PY - 2018/11/1/medline KW - calcimimetic KW - chronic kidney disease KW - dialysis KW - etelcalcetide KW - secondary hyperparathyroidism SP - 1589 EP - 1598 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 12 N2 - Secondary hyperparathyroidism (sHPT) is a frequently occurring severe complication of advanced kidney disease. Its clinical consequences include extraskeletal vascular and valvular calcifications, changes in bone metabolism resulting in renal osteodystrophy, and an increased risk of cardiovascular morbidity and mortality. Calcimimetics are a cornerstone of parathyroid hormone (PTH)-lowering therapy, as confirmed by the recently updated 2017 Kidney Disease: Improving Global Outcomes chronic kidney disease - mineral and bone disorder clinical practice guidelines. Contrary to calcitriol or other vitamin D-receptor activators, calcimimetics reduce PTH without increasing serum-calcium, phosphorus, or FGF23 levels. Etelcalcetide is a new second-generation calcimimetic that has been approved for the treatment of sHPT in adult hemodialysis patients. Whereas the first-generation calcimimetic cinacalcet is taken orally once daily, etelcalcetide is given intravenously thrice weekly at the end of the hemodialysis session. Apart from improving drug adherence, etelcalcetide has proven to be more effective in lowering PTH when compared to cinacalcet, with an acceptable and comparable safety profile. The hope for better gastrointestinal tolerance with intravenous administration did not come true, as etelcalcetide did not significantly mitigate the adverse gastrointestinal effects associated with cinacalcet. Enhanced adherence and strong reductions in PTH, phosphorus, and FGF23 could set the stage for a future large randomized controlled trial to demonstrate that improved biochemical control of mineral metabolism with etelcalcetide in hemodialysis patients translates into cardiovascular and survival benefits and better health-related quality of life. SN - 1177-8881 UR - https://wwww.unboundmedicine.com/medline/citation/29910605/Role_of_etelcalcetide_in_the_management_of_secondary_hyperparathyroidism_in_hemodialysis_patients:_a_review_on_current_data_and_place_in_therapy_ DB - PRIME DP - Unbound Medicine ER -