Parsabiv (etelcalcetide) - an allosteric modulator of the calcium-sensing receptor in hemodialysis patients with SHPT

Abstract

Patients suffering from ESRD (end-stage renal disease) have a reduced renal function, which alters the metabolism of calcium, phosphorus and vitamin D. These changes often lead to SHPT (secondary hyperparathyroidism), which is characterized by elevated levels of PTH and is often associated with hyperplasia of the parathyroid glands ( Cunningham, et al. 2011 ; Goodman and Quarles 2008 ; Joy, et al. 2007 ; Ruda, et al. 2004 ) . This chronic and progressive disease develops early in the course of CKD, worsens with reduced renal function, and affects most patients with CKD at an advanced stage. Etelcalcetide is the only calcimimetic therapy for intravenous (i.v.) administration. In addition, etelcalcetide is an allosteric activator of CaSR that binds directly to the extracellular medium. Etelcalcetide is a calcimimetic that can achieve clinically significant and sustained reductions in PTH, calcium and phosphorus levels. In addition to this i.v. method of administration of etelcalcetide also addressed some of the non-clinical reasons why patients did not follow or discontinue other SHPT treatments. In this way, etelcalcetide can provide a treatment that addresses the unmet medical need of patients with CKD and CKD.