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Use of Cinacalcet to Control Hyperparathyroidism: Treatment with cinacalcet has been shown to be safe and effective in treating primary, secondary, and tertiary hyperparathyroidism


Serra, A L; Wüthrich, R P (2008). Use of Cinacalcet to Control Hyperparathyroidism: Treatment with cinacalcet has been shown to be safe and effective in treating primary, secondary, and tertiary hyperparathyroidism. Review of Endocrinology, 2(2):41-45.

Abstract

Parathyroid hormone (PTH) secretion and calcium homeostasis are regulated via the calcium-sensing receptor (CaSR) on the chief cells of the parathyroid gland. When ionized serum calcium levels are elevated, the activation of the CaSR suppresses PTH secretion. Conversely, low calcium levels stimulate PTH secretion by reducing the CaSR activation. This tightly regulated feedback loop maintains the serum ionized calcium concentration within a very narrow range.
Agents that activate the CaSR are called calcimimetics. If calcimimetics do not require the presence of calcium to be effective, they are classified as type I calcimimetics. Calcimimetics that increase the sensitivity of the CaSR to calcium by inducing a conformational change are called type II calcimimetics.1 Cinacalcet, a phenylalkylamine compound, is the first-in-class type II calcimimetic agent approved for treatment of primary and secondary hyperparathyroidism (HPT) and has also been investigated for persistent (tertiary) HPT in patients after renal transplantation. Since 2004, cinacalcet has been marketed in the United States as Sensipar (Amgen Inc., Thousand Oaks, CA) and in Europe as Mimpara (Amgen Europe, Zug, Switzerland). This article summarizes the role of calcimimetics in the treatment of all three clinical forms of HPT.

Abstract

Parathyroid hormone (PTH) secretion and calcium homeostasis are regulated via the calcium-sensing receptor (CaSR) on the chief cells of the parathyroid gland. When ionized serum calcium levels are elevated, the activation of the CaSR suppresses PTH secretion. Conversely, low calcium levels stimulate PTH secretion by reducing the CaSR activation. This tightly regulated feedback loop maintains the serum ionized calcium concentration within a very narrow range.
Agents that activate the CaSR are called calcimimetics. If calcimimetics do not require the presence of calcium to be effective, they are classified as type I calcimimetics. Calcimimetics that increase the sensitivity of the CaSR to calcium by inducing a conformational change are called type II calcimimetics.1 Cinacalcet, a phenylalkylamine compound, is the first-in-class type II calcimimetic agent approved for treatment of primary and secondary hyperparathyroidism (HPT) and has also been investigated for persistent (tertiary) HPT in patients after renal transplantation. Since 2004, cinacalcet has been marketed in the United States as Sensipar (Amgen Inc., Thousand Oaks, CA) and in Europe as Mimpara (Amgen Europe, Zug, Switzerland). This article summarizes the role of calcimimetics in the treatment of all three clinical forms of HPT.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nephrology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:February 2008
Deposited On:23 Dec 2008 14:04
Last Modified:05 Apr 2016 12:45
Publisher:BMC Bryn Mawr Communications IV LLC

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