Etelcalcetide: a new treatment option for hyperparathyroidism

Etelcalcetide (Parsabiv) is a new injectable treatment for secondary hyperparathyroidism in adults with chronic kidney disease on haemodialysis.

Etelcalcetide is a calcimimetic agent which reduces PTH secretion by binding and activating the calcium-sensing receptor. 

The initial dose of etelcalcetide is 5mg administered by bolus injection three times weekly. Subsequent dosing is adjusted in order to achieve the desired parathyroid hormone target. Further dose adjustments may be required based on corrected serum calcium levels, which should be monitored within a week of initiation or dose adjustment of etelcalcetide and monthly during maintenance.

In patients switching from cinacalcet therapy, etelcalcetide should not be initiated until seven days after the last dose of cinacalcet and the corrected serum calcium is at or above the lower limit of the normal range.

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