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New vitamin D analogs.
Kidney Int Suppl. 2003 JunKI

Abstract

BACKGROUND

1,25-(OH)2D3 (calcitriol) controls parathyroid gland growth and suppresses the synthesis and secretion of parathyroid hormone. Because of this, 1,25-(OH)2D3 has been used successfully for the treatment of secondary hyperparathyroidism, which almost always accompanies renal failure. However, the potent effect of 1,25-(OH)2D3 on intestinal calcium and phosphorus absorption and bone mineral mobilization often leads to the development of hypercalcemia and hyperphosphatemia precluding 1,25-(OH)2D3 therapy.

METHODS

This has led to the development of vitamin D analogs that retain the suppressive action on PTH and parathyroid gland growth, but that have less calcemic and phosphatemic activity. Currently, two analogs, 19-nor-1,25-(OH)2D2 and 1,alpha(OH)D2, are being used for the treatment of secondary hyperparathyroidism in the United States, and two are being used in Japan, 22-oxa-calcitriol and 1,25-(OH)2-26,27F6 D3.

RESULTS

All four analogs suppressed PTH, but had less calcemic and phosphatemic activity than 1,25-(OH)2D3. In rats, 19-nor-1,25-(OH)2D2 has been shown to be less calcemic and phosphatemic compared to 1,alpha(OH)D2.

CONCLUSION

Therapeutic doses of 19-nor-1,25-(OH)2D2 could produce a lower Ca x P product compared to 1,alpha(OH)D2, which could be an important consideration in patient treatment. Further studies are necessary to define these differences and to understand the mechanisms behind the differential actions of vitamin D analogs.

Authors+Show Affiliations

Renal Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA. Eslatopo@im.wustl.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

12753273

Citation

Slatopolsky, Eduardo, et al. "New Vitamin D Analogs." Kidney International. Supplement, 2003, pp. S83-7.
Slatopolsky E, Finch J, Brown A. New vitamin D analogs. Kidney Int Suppl. 2003.
Slatopolsky, E., Finch, J., & Brown, A. (2003). New vitamin D analogs. Kidney International. Supplement, (85), S83-7.
Slatopolsky E, Finch J, Brown A. New Vitamin D Analogs. Kidney Int Suppl. 2003;(85)S83-7. PubMed PMID: 12753273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New vitamin D analogs. AU - Slatopolsky,Eduardo, AU - Finch,Jane, AU - Brown,Alex, PY - 2003/5/20/pubmed PY - 2004/1/17/medline PY - 2003/5/20/entrez SP - S83 EP - 7 JF - Kidney international. Supplement JO - Kidney Int Suppl IS - 85 N2 - BACKGROUND: 1,25-(OH)2D3 (calcitriol) controls parathyroid gland growth and suppresses the synthesis and secretion of parathyroid hormone. Because of this, 1,25-(OH)2D3 has been used successfully for the treatment of secondary hyperparathyroidism, which almost always accompanies renal failure. However, the potent effect of 1,25-(OH)2D3 on intestinal calcium and phosphorus absorption and bone mineral mobilization often leads to the development of hypercalcemia and hyperphosphatemia precluding 1,25-(OH)2D3 therapy. METHODS: This has led to the development of vitamin D analogs that retain the suppressive action on PTH and parathyroid gland growth, but that have less calcemic and phosphatemic activity. Currently, two analogs, 19-nor-1,25-(OH)2D2 and 1,alpha(OH)D2, are being used for the treatment of secondary hyperparathyroidism in the United States, and two are being used in Japan, 22-oxa-calcitriol and 1,25-(OH)2-26,27F6 D3. RESULTS: All four analogs suppressed PTH, but had less calcemic and phosphatemic activity than 1,25-(OH)2D3. In rats, 19-nor-1,25-(OH)2D2 has been shown to be less calcemic and phosphatemic compared to 1,alpha(OH)D2. CONCLUSION: Therapeutic doses of 19-nor-1,25-(OH)2D2 could produce a lower Ca x P product compared to 1,alpha(OH)D2, which could be an important consideration in patient treatment. Further studies are necessary to define these differences and to understand the mechanisms behind the differential actions of vitamin D analogs. SN - 0098-6577 UR - https://www.unboundmedicine.com/medline/citation/12753273/New_vitamin_D_analogs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)49273-7 DB - PRIME DP - Unbound Medicine ER -