Cinacalcet HCl:一种治疗慢性肾脏疾病引起的继发性甲状旁腺功能亢进。
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Cinacalcet HCl:一种治疗慢性肾脏疾病引起的继发性甲状旁腺功能亢进。
J任正非减轻。2006年7月,16 (3):253 - 8。
- PubMed ID
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16825031 (在PubMed]
- 文摘
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继发性甲状旁腺功能亢进(船期)发展的结果失败时钙稳态的肾脏受损干扰复杂的甲状旁腺激素之间的相互作用(素,钙、磷、维生素d。12年前,calcium-sensing受体(汽车)甲状旁腺的第一只克隆和鉴定为甲状旁腺素分泌的主要监管机构。汽车的激活小变化在细胞外钙(ec (Ca2 +))调节甲状旁腺素、降钙素分泌,尿钙排泄,最终,骨头营业额。汽车成为calcimimetics发展的理想目标,能够扩大其对ec (Ca2 +)抑制甲状旁腺素分泌。Cinacalcet HCl, first-in-class calcimimetic,批准在美国和欧盟,提供了一个新的治疗方法来治疗船期。cinacalcet HCl的疗效在治疗船期在透析病人(n = 1136),研究了三个同样的III期临床试验设计比较患者接受标准船期治疗+盐酸cinacalcet或安慰剂。Cinacalcet HCl,给从30到180毫克/天,显著降低甲状旁腺素的同时降低钙、磷和钙磷乘积的三个研究。各自的国家肾脏Foundation-Kidney疾病结果和质量计划(NKF-K / DOQI)推荐目标骨和矿物质代谢,41%的cinacalcet HCl-treated患者甲状旁腺素和钙磷乘积目标实现,而安慰剂组只有6%。最近从2阶段希望研究结果(目标和控制)进行了在美国还显示,盐酸cinacalcet可以显著降低或维持减少甲状旁腺素的同时降低钙、磷和钙磷乘积。此外,病人服用维生素D在基线的这两个试验能够看到明显意味着减少剂量的维生素D。进一步评估cinacalcet HCl试验数据显示一些重要的船期患者临床结果的影响。 A combined post-hoc analysis of clinical events using data from 4 (n = 1,184) cinacalcet HCl phase II and III studies suggests that treatment with cinacalcet HCl has a beneficial effect on relative risks of parathyroidectomy, fracture, and hospitalization for cardiovascular complications. Nausea and vomiting occurred more often in patients taking cinacalcet HCl than in those taking a placebo. There were also transient episodes of hypocalcemia in 5% of cinacalcet HCl patients versus 1% of placebo patients. However, these episodes were rarely associated with symptoms. The development of calcimimetics has already changed the treatment of SHPT in renal patients. Its effectiveness on the control of PTH secretion, along with simultaneous reductions in calcium, phosphorus, and calcium-phosphorus product, give this agent an advantage over traditional therapies in all levels of severity of SHPT.
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