Cinacalcet: A New Treatment for Secondary Hyperparathyroidism in Patients Receiving Hemodialysis

Cinacalcet is the first calcimimetic drug approved by the United States Food and Drug Administration for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease. A literature search, performed by using PubMed and MEDLINE from January 1997-June 2004, identified articles concerning the efficacy and safety of cinacalcet in this patient population. Currently, Vitamin D and its analogs are considered first-line therapy for secondary hyperparathyroidism. However, use of these agents is often accompanied by an increase in serum calcium and phosphorus concentrations, a problem that often limits their use. Cinacalcet's mechanism of action decreases parathyroid hormone, calcium, and phosphorus levels, offering potential advantages over the other treatments for secondary hyperparathyroidism. Additional clinical trials are needed to evaluate the long-term safety and efficacy of the drug as a first-line agent.