Advertisement

Treatments in Endocrinology

, Volume 4, Issue 3, pp 185–186 | Cite as

Spotlight on Paricalcitol in Secondary Hyperparathyroidism

  • Dean M. Robinson
  • Lesley J. Scott
Adis Spotlight
  • 18 Downloads

Abstract

Paricalcitol (Zemplar®) is a synthetic vitamin D2 analog that inhibits the secretion of parathyroid hormone (PTH) through binding to the vitamin D receptor. It is approved in the US and in most European nations for intravenous use in the prevention and treatment of secondary hyperparathyroidism associated with chronic renal failure in adult, and in the US pediatric, patients.

Paricalcitol effectively reduced elevated serum PTH levels and was generally well tolerated in children and adults with secondary hyperparathyroidism associated with chronic renal failure. In well designed clinical trials, paricalcitol was as effective as calcitriol and as well tolerated in terms of the incidence of prolonged hypercalcemia and/or elevated calcium-phosphorus product (Ca × P). Thus, paricalcitol is a useful option for the management of secondary hyperparathyroidism in adults and children with chronic renal failure.

Keywords

Secondary Hyperparathyroidism Maintenance Hemodialysis Paricalcitol Serum iPTH Level Patient Undergo Maintenance Hemodialysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Dusso AS, Thadhani R, Slatopolsky E. Vitamin D receptor and analogs. Semin Nephrol 2004; 24(1): 10–6PubMedCrossRefGoogle Scholar
  2. 2.
    Slatopolsky E, Cozzolino M, Lu Y, et al. Efficacy of 19-nor-1,25-(OH)2D2 in the prevention and treatment of hyperparathyroid bone disease in experimental uremia. Kidney Int 2003 Jun; 63(6): 2020–7PubMedCrossRefGoogle Scholar
  3. 3.
    Takahashi F, Finch JL, Denda M, et al. A new analog of 1,25-(OH)2D3, 19-nor-1,25-(OH)2D2, suppresses serum PTH and parathyroid gland growth in uremic rats without elevation of intestinal vitamin D receptor content. Am J Kidney Dis 1997 Jul; 30(1): 105–12PubMedCrossRefGoogle Scholar
  4. 4.
    Cozzolino M, Lu Y, Finch J, et al. p21WAFl and TGF-α mediate parathyroid growth arrest by vitamin D and high calcium. Kidney Int 2001 Dec; 60(6): 2109–17PubMedCrossRefGoogle Scholar
  5. 5.
    Balint E, Marshall CF, Sprague SM. Effect of the vitamin D analogues paricalcitol and calcitriol on bone mineral in vitro. Am J Kidney Dis 2000 Oct; 36(4): 789–96PubMedCrossRefGoogle Scholar
  6. 6.
    Finch JL, Dusso AS, Pavlopoulos T, et al. Relative potencies of 1,25-(OH)2D3 and 19-nor-1,25-(OH)2D2 on inducing differentiation and markers of bone formation in MG-63 cells. J Am Soc Nephrol 2001 Jul; 12(7): 1468–74PubMedGoogle Scholar
  7. 7.
    Slatopolsky E, Cozzolino M, Finch JL. Differential effects of 19-nor-1,25-(OH)2D2 and lα-hydroxyvitamin D2 on calcium and phosphorus in normal and uremic rats. Kidney Int 2002 Oct; 62(4): 1277–84PubMedCrossRefGoogle Scholar
  8. 8.
    Brown AJ, Finch J, Slatopolsky E. Differential effects of 19-nor-l,25-dihydroxy-vitamin D2 and 1,25-dihydroxyvitamin D3 on intestinal calcium and phosphate transport. J Lab Clin Med 2002 May; 139(5): 279–84PubMedCrossRefGoogle Scholar
  9. 9.
    Slatopolsky E, Finch J, Ritter C, et al. A new analog of calcitriol, 19-nor-l,25-(OH)2D2, suppresses parathyroid hormone secretion in uremic rats in the absence of hypercalcemia. Am J Kidney Dis 1995 Nov; 26(5): 852–60PubMedCrossRefGoogle Scholar
  10. 10.
    Slatopolsky E, Cavanaugh J, Cato A. Pharmacokinetics of paracalcin (19-nor-l-α,25-dihydroxyvitamin D2) in healthy subjects [abstract no. p428]. Nephrology (Carlton) 1997 May; 3Suppl. 1: S182Google Scholar
  11. 11.
    Cato A, Buschen C, Ahmed A, et al. The pharmacokinetics of paracalcin [abstract no. PIII-95]. 98th annual meeting of the American Society for Clinical Pharmacology and Therapeutics; 1997 Mar 5–8; San Diego, 218Google Scholar
  12. 12.
    Lee RD, Grabowski B, Johnson MK, et al. Disposition and excretion of [3H]19-nor-1α,25-dihyroxyvitamin D2 in humans [abstract no. S402]. J Bone Miner Res 1997; 12 Suppl.: S453CrossRefGoogle Scholar
  13. 13.
    Lutwak L. Medical officer’s review: paricalcitol injection [online]. Available from URL: http://www.fda.gov/cder/foi/nda/98/20819_Zemplar.htm [Accessed 2004 Sep 20]Google Scholar
  14. 14.
    Schroeder NJ, Burrin JM, Noonan K, et al. Effects of ‘non-calcaemic’ vitamin D analogues on 24-hydroxylase expression in MG-63 osteoblast-like cells. Nephron Physiol 2003; 94(4): 62–73CrossRefGoogle Scholar
  15. 15.
    Cato A, Cady WW, Soltanek C, et al. Effect of hemodialysis on the pharmacokinetics of 19-nor-1-α,25-dihydroxyvitamin D2. Am J Kidney Dis 1998 Oct; 32(2 Suppl. 2): 55–60Google Scholar
  16. 16.
    Llach F, Keshav G, Goldblat MV, et al. Suppression of parathyroid hormone secretion in hemodialysis patients by a novel vitamin D analogue: 19-nor-1,25-dihydroxyvitamin D2. Am J Kidney Dis 1998 Oct; 32(4 Suppl. 2): S48–54PubMedCrossRefGoogle Scholar
  17. 17.
    Martin KJ, Gonzalez EA, Gellens M, et al. 19-nor-1-α-25-dihydroxyvitamin D2 (paricalcitol) safely and effectively reduces the levels of intact parathyroid hormone in patients on hemodialysis. J Am Soc Nephrol 1998 Aug; 9(8): 1427–32PubMedGoogle Scholar
  18. 18.
    Sprague SM, Llach F, Amdahl M, et al. Paricalcitol versus calcitriol in the treatment of secondary hyperparathyroidism. Kidney Int 2003 Apr; 63(4): 1483–90PubMedCrossRefGoogle Scholar
  19. 19.
    Llach F, Yudd M. Paricalcitol in dialysis patients with calcitriol-resistant secondary hyperparathyroidism. Am J Kidney Dis 2001 Nov; 38(5 Suppl. 5): S45–50PubMedCrossRefGoogle Scholar
  20. 20.
    Melnick JZ, Kommala D, Mattingly S, et al. Paricalcitol and calcitriol in treating SHPT in children: a comparison of 2 studies [abstract no. SU-P0930]. Proceedings of the American Society of Nephrology; 2004 Oct 27–Nov 1; St LouisGoogle Scholar
  21. 21.
    Teng M, Wolf M, Lowrie E, et al. Survival of patients undergoing hemodialysis with paricalcitol or calcitriol therapy. N Engl J Med 2003 Jul 31; 349: 446–56PubMedCrossRefGoogle Scholar
  22. 22.
    Zemplar. Clinical review: executive summary. Summaries of medical and clinical pharmacology reviews of pediatric studies [online]. Available from URL: http:/ /www.fda.gov/cder/foi/esum/2004/20819se5-014_zemplar_clinical_bpca.pdf [Accessed 2004 Sep 15]Google Scholar
  23. 23.
    Abbott Laboratories. Zemplar® paricalcitol injection [online]. Available from URL: http://www.fda.gov [Accessed 2004 Sep 29]Google Scholar

Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  1. 1.Adis International Inc., YardleyYardleyUSA

Personalised recommendations