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Paricalcitol Doesn't Up Calcium Level In Renal Failure.

ORLANDO, FLA. -- The vitamin D analog paricalcitol is unlikely to raise serum levels of calcium and phosphorus when treating secondary hypoparathyroidism among patients with chronic renal failure.

Paricalcitol (Zemplar), which has been on the U.S. market since 1998, "suppresses parathyroid hormone [PTH] at doses that do not raise serum levels of calcium and phosphorus," Dr. Kevin J. Martin said at a meeting on clinical nephrology sponsored by the National Kidney Foundation. In several placebo-controlled trials, treatment with paricalcitol cut PTH levels by about 60% and left serum calcium and phosphorus levels virtually unchanged.

Paricalcitol has about one-fourth to one-third the potency of calcitriol for reducing PTH levels, but with one-eighth the potency of calcitriol for increasing serum calcium and phosphorus, said Dr. Martin, a professor of internal medicine at St. Louis University.

Another calcitriol analog, doxercalciferol (Hectorol), also controls PTH while modestly increasing serum calcium and phosphorus. Direct clinical comparisons of doxercalciferol and paricalcitol have not yet been reported, but comparison-studies in animals showed that paricalcitol caused less of an increase in serum calcium than did doxercalciferol, according to Dr. Martin. A head-to-head clinical study of the two analogs is needed to resolve this issue.

About 60%-70% of dialysis patients have a PTH level higher than 400 pg/mL and need some form of treatment to control their secondary hyperparathyroidism, Dr. Martin said.
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Title Annotation:Zemplar
Author:Zoler, Mitchel L.
Publication:Internal Medicine News
Article Type:Product/Service Evaluation
Geographic Code:1USA
Date:Sep 1, 2001
Previous Article:Calcimimetics Cut PTH Release, Lower Calcium.
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