Antonsen JE, Brady E, Sherrard DJ, Andress DL
A calcium receptor antagonist acutely suppresses parathyroid
hormone in dialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1810 1996
Although various medical therapies are effective in treating secondary
hyperparathyroidism, their success has been limited by the development of
hypercalcemia and/or hyperphosphatemia. Recently, a calcium receptor
agonist was developed which was shown to be a potent inhibitor of PTH
release. This study demonstrates the results of the calcium receptor
agonist, NPS R-568, on PTH levels following a single dose. Patients
received 2 doses on subsequent days and PTH levels were monitored for the
24 hours following each dose. The subjects then received a higher dose for
2 days while monitoring PTH levels. PTH levels were suppresed by over 50
%, while calcitonin levels increased by approximately 25 %. The drug was
well tolerated and neither hypo- or hyper-calcemia were observed.
Comment: This is a preliminary clinical dose-finding study
which suggests that the agent is both effective and safe in uremic
patients. It must be noted that subjects had only mild
hyperparathyroidism and limited exposure to the drug, however, the results
are promising and exciting. The discovery of the calcium receptor and the
development of agents that stimulate this receptor provides us with a new
approach for the therapy of mineral disorders. The potential use of these
agents may be much broader than for the therapy of secondary
hyperparthyroidism. Further studies are required to assess the efficacy
and safety of calcium agonist receptor therapy. See also abstract nos.
2735,
2829, and 2832.
(Stuart Sprague, M.D., Northwestern University, Chicago, IL)
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Am Soc Nephrol
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