Updates on the treatment of Secondary Hyperparathyroidism: a literature review in the last 5 years

Authors

DOI:

https://doi.org/10.33448/rsd-v11i1.23608

Keywords:

Secondary Hyperparathyroidism; Therapy; Pharmacological Treatment; Parathyroidectomy.

Abstract

Introduction: Persistent elevation in plasmatic parathyroid hormone (PTH) concentrations is responsible for a problem known as hyperparathyroidism, classified according to the origin of the breakdown of normal physiology. At the secondary hyperparathyroidism (SHPT), there is some metabolic dysfunction that leads to stimulation of the parathyroid glands, such as chronic kidney disease (CKD), the most common cause. Parathyroidectomy (PTX) has some indications in the treatment of SHPT, however, approaches such as diet adequacy, vitamin D replacement or use of drugs that control PTH secretion generate more benefits to patients than surgical intervention. Objective: To conduct a database literature review on available therapies for patients with secondary hyperparathyroidism. Methodology: A survey of articles was carried out over a period of 5 years in the Pubmed database on available therapies for patients with SHPT, finding, in the end, 19 articles. Results and Discussion: From this analysis, it was observed that new calcium-mimetics such as Etelcalcetide and Evocalcet proved to be an alternative to Cinalcacet, as they have similar efficacy and safety, but with advantages regarding use and adherence. In addition to these, Colecalciferol and Paricalcitol (calcitriol analogues) and DP0001 (new vitamin D receptor activator) are efficient in reducing serum PTH. Conclusion: Despite pointing out promising alternatives, all studies had limitations. Therefore, other studies must be developed, with a goal of defining pharmacological and technical resources capable of superimposing the treatments currently adopted.

References

Akizawa, T., Kurita, N., Mizobuchi, M., Fukagawa, M., Onishi, Y., Yamaguchi, T., ... & Fukuhara, S. (2016). PTH-dependence of the effectiveness of cinacalcet in hemodialysis patients with secondary hyperparathyroidism. Scientific reports, 6(1), 1-11.

Akizawa, T., Shimazaki, R., Shiramoto, M., & Fukagawa, M. (2018). Pharmacokinetics, pharmacodynamics, and safety of the novel calcimimetic agent evocalcet in healthy Japanese subjects: first-in-human phase I study. Clinical drug investigation, 38(10), 945-954.

Akizawa, T., Shimazaki, R., Fukagawa, M., & Evocalcet Study Group. (2018). Phase 2b study of evocalcet (KHK7580), a novel calcimimetic, in Japanese patients with secondary hyperparathyroidism undergoing hemodialysis: A randomized, double-blind, placebo-controlled, dose-finding study. PloS one, 13(10), e0204896.

Bilezikian, J. P., Bandeira, L., Khan, A., & Cusano, N. E. (2018). Hyperparathyroidism. The Lancet, 391(10116), 168-178.

Block, G. A., Bushinsky, D. A., Cunningham, J., Drueke, T. B., Ketteler, M., Kewalramani, R., ... & Chertow, G. M. (2017). Effect of etelcalcetide vs placebo on serum parathyroid hormone in patients receiving hemodialysis with secondary hyperparathyroidism: two randomized clinical trials. Jama, 317(2), 146-155.

Block, G. A., Chertow, G. M., Sullivan, J. T., Deng, H., Mather, O., Tomlin, H., & Serenko, M. (2019). An integrated analysis of safety and tolerability of etelcalcetide in patients receiving hemodialysis with secondary hyperparathyroidism. PloS one, 14(3), e0213774.

Bringhurst, F. R. (1998). Hormones and disorders of mineral metabolism. Williams Textbook of Endocrinology., 1155-1200.

Bushinsky, D. A., Chertow, G. M., Cheng, S., Deng, H., Kopyt, N., Martin, K. J., ... & Block, G. A. (2020). One-year safety and efficacy of intravenous etelcalcetide in patients on hemodialysis with secondary hyperparathyroidism. Nephrology Dialysis Transplantation, 35(10), 1769-1778.

Cruzado, J. M., Moreno, P., Torregrosa, J. V., Taco, O., Mast, R., Gómez-Vaquero, C., ... & Grinyó, J. M. (2016). A randomized study comparing parathyroidectomy with cinacalcet for treating hypercalcemia in kidney allograft recipients with hyperparathyroidism. Journal of the American Society of Nephrology, 27(8), 2487-2494.

Custódio, M. R., Canziani, M. E. F., Moysés, R. M. A., Barreto, F. C., Neves, C. L., Oliveira, R. B. D., ... & Carvalho, A. B. D. (2013). Protocolo clínico e diretrizes terapêuticas para o tratamento do hiperparatireoidismo secundário em pacientes com doença renal crônica. Brazilian Journal of Nephrology, 35, 308-322.

Diao, Z., Wang, L., Li, D., & Liu, W. (2017). Efficacy of microwave ablation for severe secondary hyperparathyroidism in subjects undergoing hemodialysis. Renal failure, 39(1), 140-145.

Fukagawa, M., Yokoyama, K., Shigematsu, T., Akiba, T., Fujii, A., Kuramoto, T., ... & ONO-5163 Study Group. (2017). A phase 3, multicentre, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of etelcalcetide (ONO-5163/AMG 416), a novel intravenous calcimimetic, for secondary hyperparathyroidism in Japanese haemodialysis patients. Nephrology Dialysis Transplantation, 32(10), 1723-1730.

Golan, David E. et al. (2014) Princípios de farmacologia: a base fisiopatológica da farmacoterapia. 3. ed. Rio de Janeiro: Guanabara Koogan.

Guyton, A.C.; Hall, J.E. (2011) Tratado de Fisiologia Médica. 12. ed. Rio de Janeiro: Elsevier.

Neves, P. D. M. D. M., Sesso, R. D. C. C., Thomé, F. S., Lugon, J. R., & Nasicmento, M. M. (2020). Brazilian Dialysis Census: analysis of data from the 2009-2018 decade. Brazilian Journal of Nephrology, 42, 191-200.

Olaizola, I., Caorsi, H., Fajardo, L., Ferreiro, A., Campistrus, N., Dolinsky, D., ... & Ambrosoni, P. (2016). Effectiveness and safety of a 6-month treatment with paricalcitol in patients on hemodialysis with secondary hyperparathyroidism. Brazilian Journal of Nephrology, 38, 302-312.

Pandey, R., Zella, J. B., Zhu, J. G., Plum, L. A., Clagett-Dame, M., Blaser, W. J., ... & Coyne, D. W. (2017). Pharmacokinetics of a New Oral Vitamin D Receptor Activator (2-Methylene-19-Nor-(20S)-1α, 25-Dihydroxyvitamin D 3) in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism on Hemodialysis. Drugs in R&D, 17(4), 597-605.

Porto, R. A., Truite, M. R., Bucharles, S. E., & Hauser, A. B. (2016). Hiperparatireoidismo secundário: uma complicação da Doença Renal Crônica. Rev. Bras. Anal. Clin, 48(3), 182-188.

SBEM (Sociedade Brasileira de Endocrinologia e Metabologia). (2006) Hiperparatireoidismo Primário, Projeto Diretrizes.

Shigematsu, T., Shimazaki, R., Fukagawa, M., Akizawa, T., & Evocalcet Study Group. (2019). Pharmacodynamics of evocalcet for secondary hyperparathyroidism in Japanese hemodialysis patients. Clinical and experimental nephrology, 23(2), 258-267.

Susantitaphong, P., Vadcharavivad, S., Susomboon, T., Singhan, W., Dumrongpisutikul, N., Jakchairoongruang, K., ... & Praditpornsilpa, K. (2019). The effectiveness of cinacalcet: a randomized, open label study in chronic hemodialysis patients with severe secondary hyperparathyroidism. Renal failure, 41(1), 326-333.

Tsuruya, K., Shimazaki, R., Fukagawa, M., & Akizawa, T. (2019). Efficacy and safety of evocalcet in Japanese peritoneal dialysis patients. Clinical and experimental nephrology, 23(6), 739-748.

Webb, N. J., Lerner, G., Warady, B. A., Dell, K. M., Greenbaum, L. A., Ariceta, G., ... & Dufek, M. B. (2017). Efficacy and safety of paricalcitol in children with stages 3 to 5 chronic kidney disease. Pediatric Nephrology, 32(7), 1221-1232.

Westerberg, P. A., Sterner, G., Ljunggren, Ö., Isaksson, E., Elvarson, F., Dezfoolian, H., & Linde, T. (2018). High doses of cholecalciferol alleviate the progression of hyperparathyroidism in patients with CKD Stages 3–4: results of a 12-week double-blind, randomized, controlled study. Nephrology Dialysis Transplantation, 33(3), 466-471.

Xavier, Cláudia M. (2020) Tratamento cirúrgico do hiperparatireoidismo primário.

Yokoyama, K., Shimazaki, R., Fukagawa, M., & Akizawa, T. (2019). Long-term efficacy and safety of evocalcet in Japanese patients with secondary hyperparathyroidism receiving hemodialysis. Scientific reports, 9(1), 1-11.

Jiang, Y., Zhang, J., Yuan, Y., Zha, X., Xing, C., Shen, C., ... & Wang, N. (2016). Association of increased serum leptin with ameliorated anemia and malnutrition in stage 5 chronic kidney disease patients after parathyroidectomy. Scientific reports, 6(1), 1-13.

Zheng, J. Q., Hou, Y. C., Zheng, C. M., Lu, C. L., Liu, W. C., Wu, C. C., ... & Lu, K. C. (2016). Cholecalciferol additively reduces serum parathyroid hormone and increases vitamin D and cathelicidin levels in paricalcitol-treated secondary hyperparathyroid hemodialysis patients. Nutrients, 8(11), 708.

Published

03/01/2022

How to Cite

GUIMARÃES, A. B. .; SILVA, F. P. .; SILVA, J. M. R. .; PINHEIRO, A. C. S. de O. .; CRISTO, J. V. M. .; SILVA, F. S. da .; BASEGGIO, L. T. .; PARENTE, F. de S. .; SANTOS, B. S. dos . Updates on the treatment of Secondary Hyperparathyroidism: a literature review in the last 5 years. Research, Society and Development, [S. l.], v. 11, n. 1, p. e11011123608, 2022. DOI: 10.33448/rsd-v11i1.23608. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/23608. Acesso em: 16 apr. 2024.

Issue

Section

Health Sciences