Calcifediol may more be effective at correcting 25-hydroxyvitamin D—25(OH)D—deficiency and reducing parathyroid hormone (PTH) levels in pre-dialysis patients than cholecalciferol and ergocalciferol, according to an expert panel.

Although optimal targets of 25(OH)D and PTH levels remain uncertain, calcifediol, especially in its newer modified release formulation, “may represent an intriguing option to combine an efficacious correction of 25(OH)D deficit and SHPT, with a limited impact on vitamin D catabolism and FGF-23 activation,” Andrea Galassi, MD, and colleagues at the University of Milan in Italy, wrote in Expert Review of Clinical Pharmacology.

Calcifediol has better bioavailability, the authors wrote. The newer modified release formulation also has a safer pharmacokinetic profile with little impact on vitamin D catabolism and fibroblast-growth factor-23 (FGF-23) activation. The panel encouraged future research to confirm these purported benefits. They further noted that newer drugs for chronic kidney disease-mineral and bone disorder, such as new oral calcimimetics and anti-sclerostin antibodies, are expected.

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Galassi A, Bellasi A, Ciceri P, Pivari F, Conte F, and Cozzolino M. Calcifediol to treat secondary hyperparathyroidism in patients with chronic kidney disease. Exp Rev Clin Pharm, doi: 10.1080/17512433.2017.1371011