[ Summary ] |
Maxacalcitol (OCT) is a vitamin D analogue with strong suppressive effects on parathyroid function and able to lower calcemic action. OCT is now applicable to the treatment of secondary hyperparathyroidism (2°HPT) which is resistant to conventional treatment. The treatment of 2°HPT using OCT requires careful dosage adjustment to maintain appropriate serum Ca, phosphorus, bone marker and PTH levels. For patients with refractory 2°HPT who show symptoms of hypercalcemia and/or high PTH levels in spite of OCT administration, other treatments including para thyroidectomy or parathyroid intervention therapies should be considered. On the other hand, for the excessive reduction of PTH levels, temporary discontinuation and/or reduction of dosage of OCT may be required. For patients with sustained low PTH levels, orals vitamin D therapy, with careful attention to 2°HPT relapse, should be selected. |