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Cinacalcet as alternative treatment for primary hyperparathyroidism: achievements and prospects.

Author(s): Duntas LH, Stathatos N

Affiliation(s): Endocrine Unit, Evgenidion Hospital, University of Athens, 20 Papadiamantopoulou Str, 11528, Athens, Greece. ledunt@otenet.gr

Publication date & source: 2011-06, Endocrine., 39(3):199-204. Epub 2011 Mar 26.

Publication type: Review

Primary hyperparathyroidism (pHPT), which most frequently occurs asymptomatically, is a common endocrine disease associated with increased morbidity and mortality. The newly introduced management guidelines as well as the recent availability of the first calcimimetic offer a highly promising therapeutic option for patients with pHPT. Cinacalcet, the first available calcimimetic, increases the sensitivity of the calcium-sensing receptor (CaR) to circulating serum calcium, thereby safely reducing serum calcium and PTH concentrations in patients with mild-to-moderate pHPT, intractable disease, and also parathyroid carcinoma. Cinacalcet has proved efficient in short- and long-term controls of hypercalcemia and, though bone mineral density was not improved, the available data point to cinacalcet as the treatment of choice in non-operable patients with pHPT. These results encompass a wide spectrum of disease severity. Results are pending as to whether cinacalcet decreases mortality and morbidity in pHPT, confirmation of which would conclusively recommend this drug as a valid alternative to surgery.

Page last updated: 2011-12-09

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