Cinacalcet Hydrochloride

Excerpt

Secondary hyperparathyroidism (HPT) is a progressive and detrimental disease associated with chronic kidney disease (CKD). Although surgical parathyroidectomy (PTX) remains the gold standard therapy for severe secondary HPT, it is not without risk. PTX exposes patients to anaesthesia risks, potential surgical complications, and may result in a permanent state of hypoparathyroidism. On the other hand, current medical treatments, such as calcium salts and vitamin D derivatives, are limited by hypercalcaemia, hyperphosphataemia and an increase in serum calcium-phosphorus product (Ca × P). Therefore, there was a need for a drug that efficiently, safely, and cyclically reduces parathyroid hormone (PTH) secretion. The discovery of the extracellular calcium-sensing receptor (CaR) and the recognition that its activation by changes in extracellular ionised calcium regulates PTH, led to the development of calcimimetics that act to amplify the sensitivity of the CaR to extracellular ionised calcium. …