二次性副甲状腺機能冗進症治療薬マキサカルシトールの臨床的評価

Abstract

The effects of intravenous injection treatment with maxacalcitol were compared with those of oral pulse therapy with calcitriol in patients with secondary hyperparathyroidism who were undergoing hemodialysis in Yao Tokushukai General Hospital. In the maxacalcitol treated group (n=5), the patients were injected with 5μ g of maxacalcitol with a serum parathyroid hormone-intact (i-PTH) level of 350pg/mL or more after dialysis 3 times a week. While in the calcitriol treated group, 2μg of calcitriol was orally administered twice a week. The subsequent dose was regulated based on the serum i-PTH and serum Ca levels. As a result, there was no significant difference in the inhibitory effects on the serum i-PTH levels between the two groups. The rates of increase in the serum Ca levels were also similar. When the responders to the administration of maxacalcitol were compared to the non-responders, the serum P levels were within the normal range. It may be important to control the serum P levels as an index during the administration of maxacalcitol. The long-term administration of maxacalcitol to patients who may respond to oral pulse therapy with calcitoriol was inexpedient from the perspective of medical costs. Furthermore, an increase in the serum Ca levels should be considered during admini-stration.In the future, patients for whom each pulse therapy is indicated and the optimal administration method of maxacalcitol should be further investigated.