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Calcifediol to treat secondary hyperparathyroidism in patients with chronic kidney disease.
Expert Rev Clin Pharmacol. 2017 Oct; 10(10):1073-1084.ER

Abstract

INTRODUCTION

Deranged vitamin D metabolism represents an active trigger of secondary hyperparathyroidism (SHPT) in CKD. Correction of 25(OH)D deficiency by nutritional Vitamin D administration is suggested by KDIGO guidelines, to prevent and treat SHPT in CKD stage G3-G5 and G1T-G5T patients, although with a still inconsistent background. Nutritional vitamin D is available as cholecalciferol, ergocalciferol, or calcifediol. Superiority of calcifediol in increasing 25(OH)D levels has been suggested due to its better bioavailability. The safer pharmacokinetic of the recent modified-release (MR) formulation of calcifediol was effective in replenishing 25(OH)D levels with minimal impact on vitamin D catabolism and fibroblast-growth factor-23 (FGF-23) activation. Areas covered: the review discusses utility of calcifediol for treating SHPT in different CKD stages under physiology driven approach, focusing on vitamin D metabolism, guidelines suggestions and comparison between clinical effects on SHPT elicited by calcifediol, cholecalciferol and ergocalciferol. Expert commentary: although optimal targets of 25(OH)D and parathormone remain uncertain, calcifediol, especially in its newer MR formulation, may represent an intriguing option to combine an efficacious correction of 25(OH)D deficit and SHPT, with a limited impact on vitamin D catabolism and FGF-23 activation. Newer data are required to better explore the role of MR calcifediol in treating SHPT.

Authors+Show Affiliations

a Department of Health Sciences, Renal Division , University of Milan , Milan , Italy.a Department of Health Sciences, Renal Division , University of Milan , Milan , Italy. b Renal & Dialysis Unit ASST Lariana , S. Anna Hospital , Como , Italy.a Department of Health Sciences, Renal Division , University of Milan , Milan , Italy.a Department of Health Sciences, Renal Division , University of Milan , Milan , Italy.a Department of Health Sciences, Renal Division , University of Milan , Milan , Italy.a Department of Health Sciences, Renal Division , University of Milan , Milan , Italy.

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

28846459

Citation

Galassi, Andrea, et al. "Calcifediol to Treat Secondary Hyperparathyroidism in Patients With Chronic Kidney Disease." Expert Review of Clinical Pharmacology, vol. 10, no. 10, 2017, pp. 1073-1084.
Galassi A, Bellasi A, Ciceri P, et al. Calcifediol to treat secondary hyperparathyroidism in patients with chronic kidney disease. Expert Rev Clin Pharmacol. 2017;10(10):1073-1084.
Galassi, A., Bellasi, A., Ciceri, P., Pivari, F., Conte, F., & Cozzolino, M. (2017). Calcifediol to treat secondary hyperparathyroidism in patients with chronic kidney disease. Expert Review of Clinical Pharmacology, 10(10), 1073-1084. https://doi.org/10.1080/17512433.2017.1371011
Galassi A, et al. Calcifediol to Treat Secondary Hyperparathyroidism in Patients With Chronic Kidney Disease. Expert Rev Clin Pharmacol. 2017;10(10):1073-1084. PubMed PMID: 28846459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcifediol to treat secondary hyperparathyroidism in patients with chronic kidney disease. AU - Galassi,Andrea, AU - Bellasi,Antonio, AU - Ciceri,Paola, AU - Pivari,Francesca, AU - Conte,Ferruccio, AU - Cozzolino,Mario, Y1 - 2017/09/04/ PY - 2017/8/29/pubmed PY - 2017/10/14/medline PY - 2017/8/29/entrez KW - 25-hydroxyvitaminD3 KW - CKD KW - Calcifediol KW - FGF-23 KW - secondary hyperparathyroidism SP - 1073 EP - 1084 JF - Expert review of clinical pharmacology JO - Expert Rev Clin Pharmacol VL - 10 IS - 10 N2 - INTRODUCTION: Deranged vitamin D metabolism represents an active trigger of secondary hyperparathyroidism (SHPT) in CKD. Correction of 25(OH)D deficiency by nutritional Vitamin D administration is suggested by KDIGO guidelines, to prevent and treat SHPT in CKD stage G3-G5 and G1T-G5T patients, although with a still inconsistent background. Nutritional vitamin D is available as cholecalciferol, ergocalciferol, or calcifediol. Superiority of calcifediol in increasing 25(OH)D levels has been suggested due to its better bioavailability. The safer pharmacokinetic of the recent modified-release (MR) formulation of calcifediol was effective in replenishing 25(OH)D levels with minimal impact on vitamin D catabolism and fibroblast-growth factor-23 (FGF-23) activation. Areas covered: the review discusses utility of calcifediol for treating SHPT in different CKD stages under physiology driven approach, focusing on vitamin D metabolism, guidelines suggestions and comparison between clinical effects on SHPT elicited by calcifediol, cholecalciferol and ergocalciferol. Expert commentary: although optimal targets of 25(OH)D and parathormone remain uncertain, calcifediol, especially in its newer MR formulation, may represent an intriguing option to combine an efficacious correction of 25(OH)D deficit and SHPT, with a limited impact on vitamin D catabolism and FGF-23 activation. Newer data are required to better explore the role of MR calcifediol in treating SHPT. SN - 1751-2441 UR - https://www.unboundmedicine.com/medline/citation/28846459/Calcifediol_to_treat_secondary_hyperparathyroidism_in_patients_with_chronic_kidney_disease_ L2 - https://www.tandfonline.com/doi/full/10.1080/17512433.2017.1371011 DB - PRIME DP - Unbound Medicine ER -