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Safety and tolerability of paricalcitol in patients with chronic kidney disease.
Expert Opin Drug Saf. 2013 Sep; 12(5):717-28.EO

Abstract

INTRODUCTION

Secondary hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD). Beyond skeletal complications, uncontrolled SHPT is associated with cardiovascular mortality. Vitamin D receptor activators (VDRAs) are a mainstay of therapy for SHPT; however, use is limited by hypercalcemia, though less so with calcitriol analogs such as paricalcitol and there is emerging experience with oral formulations for non-SHPT indications. The role of VDRAs in the treatment of SHPT becomes a complex question as alternative strategies have developed.

AREAS COVERED

This review summarizes trials that established the safety and efficacy of paricalcitol for SHPT. Comparative experience with paricalcitol as against other VDRAs will be reviewed as will the experience with paricalcitol in non-dialysis CKD and comparative experience with non-VDRA-based therapy.

EXPERT OPINION

VDRA therapy is considered first-line therapy for treatment of SHPT. Paricalcitol has demonstrated superiority to calcitriol with respect to parathyroid hormone suppression and calcium-phosphorus balance. Oral formulations of paricalcitol appear to be similarly effective for SHPT. While there is evidence to suggest adjunctive antiproteinuria benefit with the use of VDRAs, efficacy of these agents to slow the progression of CKD or to reduce cardiovascular risk has not yet been demonstrated.

Authors+Show Affiliations

University of Texas Health Science Center San Antonio, Medicine/Nephrology, South Texas Veterans Health Care System, 7703 Floyd Curl Dr, MC 7882, San Antonio 78229, USA. DyerCA@uthscsa.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23621417

Citation

Dyer, Christopher A.. "Safety and Tolerability of Paricalcitol in Patients With Chronic Kidney Disease." Expert Opinion On Drug Safety, vol. 12, no. 5, 2013, pp. 717-28.
Dyer CA. Safety and tolerability of paricalcitol in patients with chronic kidney disease. Expert Opin Drug Saf. 2013;12(5):717-28.
Dyer, C. A. (2013). Safety and tolerability of paricalcitol in patients with chronic kidney disease. Expert Opinion On Drug Safety, 12(5), 717-28. https://doi.org/10.1517/14740338.2013.791675
Dyer CA. Safety and Tolerability of Paricalcitol in Patients With Chronic Kidney Disease. Expert Opin Drug Saf. 2013;12(5):717-28. PubMed PMID: 23621417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and tolerability of paricalcitol in patients with chronic kidney disease. A1 - Dyer,Christopher A, Y1 - 2013/04/29/ PY - 2013/4/30/entrez PY - 2013/4/30/pubmed PY - 2014/4/3/medline SP - 717 EP - 28 JF - Expert opinion on drug safety JO - Expert Opin Drug Saf VL - 12 IS - 5 N2 - INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD). Beyond skeletal complications, uncontrolled SHPT is associated with cardiovascular mortality. Vitamin D receptor activators (VDRAs) are a mainstay of therapy for SHPT; however, use is limited by hypercalcemia, though less so with calcitriol analogs such as paricalcitol and there is emerging experience with oral formulations for non-SHPT indications. The role of VDRAs in the treatment of SHPT becomes a complex question as alternative strategies have developed. AREAS COVERED: This review summarizes trials that established the safety and efficacy of paricalcitol for SHPT. Comparative experience with paricalcitol as against other VDRAs will be reviewed as will the experience with paricalcitol in non-dialysis CKD and comparative experience with non-VDRA-based therapy. EXPERT OPINION: VDRA therapy is considered first-line therapy for treatment of SHPT. Paricalcitol has demonstrated superiority to calcitriol with respect to parathyroid hormone suppression and calcium-phosphorus balance. Oral formulations of paricalcitol appear to be similarly effective for SHPT. While there is evidence to suggest adjunctive antiproteinuria benefit with the use of VDRAs, efficacy of these agents to slow the progression of CKD or to reduce cardiovascular risk has not yet been demonstrated. SN - 1744-764X UR - https://www.unboundmedicine.com/medline/citation/23621417/Safety_and_tolerability_of_paricalcitol_in_patients_with_chronic_kidney_disease_ L2 - https://www.tandfonline.com/doi/full/10.1517/14740338.2013.791675 DB - PRIME DP - Unbound Medicine ER -