Paricalcitol and cinacalcet are similarly effective in decreasing parathyroid hormone (PTH) levels in patients with secondary hyperparathyroidism (SHPT) and chronic kidney disease, according to new research.
Weigang Tang, MD, of Jiangsu University in Jiangsu, China, and colleagues performed a meta-analysis of 7 trials comprising 456 patients receiving paricalcitol, a selective vitamin D analog, and 412 receiving cinacalcet, a calcimimetic. According to results published in Experimental and Therapeutic Medicine, the investigators found no significant mean differences in serum PTH or phosphorus levels. Serum calcium levels, however, were a significant 10% higher in the paricalcitol group (P <.05).
Paricalcitol’s effect on the intestine and bone is only a tenth of that of calcitriol (active vitamin D), and therefore poses less risk of hypercalcemia and hyperphosphatemia, the team noted.
The investigators were unable to thoroughly examine the proportion of patients in each group who achieved target range PTH (150-300 pg/mL). They also could not fully study the incidence of hypocalcemia, hypercalcemia, hyperphosphatemia, adverse events, and cost because those measures were not included in all studies. The team encouraged future, large, multicenter randomized controlled trials to determine optimal SHPT therapy.
“In conclusion, the present meta-analysis revealed that paricalcitol and cinacalcet were effective for decreasing PTH levels. There was no difference between the two novel drugs concerning the management of PTH and phosphorus levels,” Dr Tang and colleagues wrote.
Xu W, Gong L, Lu J, Tang W. Paricalcitol vs. cinacalcet for secondary hyperparathyroidism in chronic kidney disease: a meta-analysis. Exp Ther Med. Oct;20(4):3237-3243. Published online Jul 24, 2020. doi:10.3892/etm.2020.9044