Paricalcitol is Still the Best First Line Treatment for Secondary Hyperparathyroidism (SHPT)


ParicalcitolSecondary hyperparathyroidism (SHPT) is a common complication associated with chronic renal failure. The damaged kidneys do not convert enough vitamin D to its active form, calciferol, and inadequately excrete phosphate. This results in the formation of insoluble calcium phosphate in the body and removal of calcium from the blood circulation. Both processes lead to hypocalcemia, thus secondary hyperparathyroidism. The condition if left untreated may result from malabsorption (chronic pancreatitis, small bowel disease, malabsorption-dependent bariatric surgery) of the fat soluble vitamin D. The resulting hypocalcemia and subsequent increased parathyroid hormone secretion is an attempt by the body to increase the serum calcium levels. The current recommended treatment for SHPT is vitamin D–receptor activator such as paricalcitol, or a calcimimetic such as cinacalcet.

Dr Markus Ketteler

Markus Ketteler, MD

Markus Ketteler, MD, of the Klinikum Coburg’s nephrology division in Germany, told delegates that until now, the comparative effectiveness of the paricalcitol and cinacalcet treatments had not been evaluated in patients undergoing hemodialysis. The study used initial doses of paricalcitol were 0.07 μg/kg IV or PTH/80 orally. The initial cinacalcet dose was 30 mg. The results of the study point to IV paricalcitol being superior to cinacalcet plus IV doxercalciferol in achieving a mean serum iPTH level that is normal (150 to 300 pg/mL), and fewer patients treated with IV paricalcitol had serum calcium levels that indicated hypercalcemia.

Dr. Ketteler confirmed paricalcitol’s superior efficacy over cinacalcet by showing the PTH (parathyroid hormone) levels improvement of the patients involved in the study.

Economically speaking, costs for paricalcitol treatment were 40% lower than for cinacalcet treatment. This was based on the American wholesale pricing and taking into account the various paricalcitol, cinacalcet, and vitamin D preparations.

Another nephrologist, Dr. Johannes Mann, MD, professor of medicine and director of the Department of Nephrology at Munich General Hospitals in Germany said that there are more patient-relevant parameters to look at than the PTH levels. “Secondary hyperparathyroidism (SHPT) is associated with vascular calcifications and may result, in heart failure, myocardial infarctions, strokes. Also, because of the redistribution of calcium from the bone to the vasculature, it may be associated with bone fractures,” he said.

This is where LGM Pharma and its pharmaceutical partners come in. The company is cognizant of the opportunity to improve on an existing drug based on solid scientific data like the one mentioned above. Paricalcitol CAS # 131918-61-1 clearly demonstrated greater efficacy than its counterpart product in the market in improving clinical parameters of SHPT. LGM Pharma seeks to support Companies and institutions currently working on translating these improvements in clinical parameters to better quality of life, reduced incidence of bone damage and longer survival period. LGM Pharma supplies Paricalcitol as a research molecule to pharmaceutical firms keen on this research pursuit.

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