Kidney and Metabolic Bone Diseases Vol.31 No.4(6)

Theme New frontiers of calcimimetics
Title Evocalcet
Publish Date 2018/09
Author Naoto Hamano Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine
Author Masafumi Fukagawa Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine
[ Summary ] Treatment of secondary hyperparathyroidism with cinacalcet is beneficial and may improve clinical outcomes for patients undergoing hemodialysis. Gastrointestinal-related adverse events (GI-related AEs) induced by cinacalcet are the primary cause of lower adherence with patients using this agent. Insufficient dosage results in insufficient treatment of SHPT. Evocalcet is a novel calcimimetic for the treatment of SHPT. Basic research revealed that GI-related AEs and cytochrome P450 inhibition caused by evocalcet were alleviated compared to results achieved with cinacalcet. A phase 3 trial was designed in Japan to compare the clinical efficacy and safety of evocalcet to that of cinacalcet. Decreases in PTH levels in the evocalcet group and the cinacalcet group were comparable. The frequency of GI-related AEs was significantly lower in the evocalcet group. However, whether lower frequency of GI-related AEs can provide better adherence with evocalcet than that with cinacalcet remains unknown. Further research is required to elucidate whether evocalcet improves clinical outcomes for patients with SHPT.
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