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Calcimimetic and Calcilytic Drugs: Feats, Flops, and Futures
1MetisMedica, 13 Poplar Plains Road, Toronto, ON, M4V 2M7, Canada. nemeth.ed@gmail.com.
Calcified Tissue International
|August 31, 2015
Summary
Calcimimetics, like cinacalcet, effectively manage secondary hyperparathyroidism by lowering parathyroid hormone (PTH) and improving bone health in dialysis patients. Calcilytics, CaR antagonists, show potential for other conditions beyond osteoporosis.
Area of Science:
- Endocrinology
- Nephrology
- Pharmacology
Background:
- The extracellular calcium-sensing receptor (CaR) regulates parathyroid and kidney functions, crucial for calcium homeostasis.
- CaR is a key target for treating bone and mineral disorders.
Purpose of the Study:
- To review the role of calcimimetics and calcilytics in managing conditions related to CaR signaling.
- To highlight the clinical utility of cinacalcet and potential of calcilytics.
Main Methods:
- Literature review of calcimimetics (type I and II) and calcilytics.
- Analysis of clinical outcomes associated with cinacalcet use in secondary hyperparathyroidism.
- Evaluation of calcilytic development for osteoporosis and potential new indications.
Main Results:
- Type II calcimimetics, such as cinacalcet, effectively reduce PTH, phosphorus, and FGF23 in dialysis patients with secondary hyperparathyroidism.
- Cinacalcet improves bone histopathology and may reduce fracture risk and parathyroidectomy necessity.
- Second-generation calcimimetics are under review; calcilytics failed in osteoporosis trials but may be repurposed.
Conclusions:
- Calcimimetics are valuable therapeutic agents for disorders of mineral metabolism.
- Calcilytics, despite past failures, may offer future therapeutic potential for other CaR-related conditions.
Keywords:
Autosomal dominant hypocalcemiaCalcilyticCalcimimeticCalcium-sensing receptorCinacalcetHyperparathyroidismOsteoporosisMore Related Videos
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