Cinacalcet as alternative treatment for primary hyperparathyroidism: achievements and prospects.

Abstract

Primary hyperparathyroidism (pHPT), which most frequently occurs asymptomatically, is a common endocrine disease associated with increased morbidity and mortality. The newly introduced management guidelines as well as the recent availability of the first calcimimetic offer a highly promising therapeutic option for patients with pHPT. Cinacalcet, the first available calcimimetic, increases the sensitivity of the calcium-sensing receptor (CaR) to circulating serum calcium, thereby safely reducing serum calcium and PTH concentrations in patients with mild-to-moderate pHPT, intractable disease, and also parathyroid carcinoma. Cinacalcet has proved efficient in short- and long-term controls of hypercalcemia and, though bone mineral density was not improved, the available data point to cinacalcet as the treatment of choice in non-operable patients with pHPT. These results encompass a wide spectrum of disease severity. Results are pending as to whether cinacalcet decreases mortality and morbidity in pHPT, confirmation of which would conclusively recommend this drug as a valid alternative to surgery.

• Authors: Leonidas H Duntas, Nikolaos Stathatos
• Journal: Endocrine (Endocrine) Vol. 39 Issue 3 Pg. 199-204 (Jun 2011) ISSN: 1559-0100 [Electronic] United States
• PMID: 21442382 (Publication Type: Journal Article, Review)

Chemical References

• Calcimimetic Agents
• Diphosphonates
• Naphthalenes
• Selective Estrogen Receptor Modulators
• Cinacalcet

Topics

• Calcimimetic Agents (therapeutic use)
• Cinacalcet
• Contraindications
• Diphosphonates (therapeutic use)
• Endocrine Surgical Procedures
• Humans
• Hyperparathyroidism, Primary (drug therapy, mortality, surgery)
• Naphthalenes (adverse effects, therapeutic use)
• Selective Estrogen Receptor Modulators (therapeutic use)