Upacicalcet: A Novel Intravenous Calcimimetic Agent for Patients Undergoing Hemodialysis With Secondary Hyperparathyroidism

Secondary hyperparathyroidism (SHPT) is a common complication in patients receiving maintenance dialysis, driven by calcium and phosphate metabolism disturbances. Calcimimetics are central to the management of SHPT by enhancing calcium-sensing receptor sensitivity and reducing parathyroid hormone secretion. Upacicalcet is a novel intravenous calcimimetic that was specifically developed for hemodialysis patients. It is efficiently removed by hemodialysis, does not undergo hepatic metabolism, and has minimal potential for drug-drug interactions. Clinical studies have shown that upacicalcet effectively lowers serum intact parathyroid hormone and improves associated biochemical markers such as fibroblast growth factor-23 and bone turnover indices. It demonstrates a low incidence of gastrointestinal symptoms and hypocalcemia. Upacicalcet achieves sustained biochemical control with good tolerability in long-term use. These features suggest that upacicalcet is a safe and ideal option for the long-term management of SHPT in patients undergoing hemodialysis.