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Condition

Secondary Hyperparathyroidism

Secondary hyperparathyroidism happens when the parathyroid glands make too much parathyroid hormone (PTH), usually because failing kidneys leave calcium low and phosphate high. Evidence is strongest for etelcalcetide, a calcimimetic medicine: trials found about three in four people had PTH fall by over 30%, versus one in ten on placebo, and it beat cinacalcet head to head. Those results came mainly from people on hemodialysis, so they may not apply to everyone with the condition.

Sources: PMID 32729818; PMID 32475604

Supplements studied
0
Medicines and peptides
1
Graded outcomes
5
No supplement studies yetWe haven’t found supplement studies for Secondary Hyperparathyroidism. The medicines and peptides studied for it are listed below.

Prescription medicines and peptides studied, for context

These are not supplements. Most need a prescription, and some are research compounds with no approved use.

1 medicine or peptide

Etelcalcetide (Parsabiv)

Etelcalcetide (Parsabiv): outcomes studied for Secondary Hyperparathyroidism
GradeOutcomeEffectSizeStudiesPeopleStudies list
Serum Calcium

Effective reduction in serum calcium levels, though hypocalcemia-related adverse events require monitoring and dose adjustment.

Improves (the measure goes down)Moderate effect34 studies

Studies that measured serum calcium

and 31 more on the Etelcalcetide (Parsabiv) page

Serum Phosphorus

Reduction in serum phosphorus levels observed alongside PTH reduction in clinical trials.

Improves (the measure goes down)Moderate effect32 studies

Studies that measured serum phosphorus

and 29 more on the Etelcalcetide (Parsabiv) page

PTH Reduction

74-75% achieved >30% PTH reduction vs 8-10% placebo. Real-world: median PTH from 636 to 357 pg/mL. Superior to cinacalcet in head-to-head trial.

Improves (the measure goes down)Large effect31 studies

Studies that measured pth reduction

and 28 more on the Etelcalcetide (Parsabiv) page

PTH Target Achievement

Significant increase in patients achieving PTH targets (150-600 pg/mL). Responder rate increased from 27% to 63% in real-world study.

Improves (the measure goes up)Large effect31 studies

Studies that measured pth target achievement

and 28 more on the Etelcalcetide (Parsabiv) page

FGF23 Levels

Secondary decrease in fibroblast growth factor-23 levels associated with improved mineral metabolism.

Improves (the measure goes down)Moderate effect30 studies

Studies that measured fgf23 levels

and 27 more on the Etelcalcetide (Parsabiv) page

Key findings

  • Serum CalciumEtelcalcetide (Parsabiv)Improves (the measure goes down)
  • Serum PhosphorusEtelcalcetide (Parsabiv)Improves (the measure goes down)
  • PTH ReductionEtelcalcetide (Parsabiv)Improves (the measure goes down)

Safety notes in the studies

  • Effective reduction in serum calcium levels, though hypocalcemia-related adverse events require monitoring and dose adjustment.

Studies cited

43 studies from PubMed

  1. Adverse events reporting of Etelcalcetide: a real-word analysis from FAERS database.Journal of pharmaceutical policy and practice, 2025 · PMID 40170738
  2. Real-world safety profile of etelcalcetide in dialysis-related secondary hyperparathyroidism: a pharmacovigilance analysis of FAERS data.Renal failure, 2025 · PMID 40605277
  3. The calcium-sensing receptor: a comprehensive review on its role in calcium homeostasis and therapeutic implications.American journal of translational research, 2025 · PMID 40226019
  4. Calcimimetics treatment strategy for serum calcium and phosphate management in patients with secondary hyperparathyroidism undergoing dialysis: A systematic review and meta-analysis of randomized studies.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 2024 · PMID 38499495
  5. Effects of active vitamin D analogs and calcimimetic agents on PTH and bone mineral biomarkers in hemodialysis patients with SHPT: a network meta-analysis.European journal of clinical pharmacology, 2024 · PMID 39002024
  6. Effect of etelcalcetide versus alfacalcidol on left ventricular function and feature-tracking cardiac magnetic resonance imaging in hemodialysis-a post-hoc analysis of a randomized, controlled trial.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2023 · PMID 37932788
  7. Etelcalcetide Utilization, Dosing Titration, and Chronic Kidney Disease-Mineral and Bone Disease (CKD-MBD) Marker Responses in US Hemodialysis Patients.American journal of kidney diseases : the official journal of the National Kidney Foundation, 2022 · PMID 34273436
  8. Cardio-renal interaction - Clinical trials update 2022.Nutrition, metabolism, and cardiovascular diseases : NMCD, 2022 · PMID 36064690
  9. Phase 1, single-dose study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of etelcalcetide in pediatric patients with secondary hyperparathyroidism receiving hemodialysis.Pediatric nephrology (Berlin, Germany), 2021 · PMID 32647975
  10. Safety and efficacy of etelcalcetide, an intravenous calcimimetic, for up to 52 weeks in hemodialysis patients with secondary hyperparathyroidism: results of a post-marketing surveillance in Japan.Clinical and experimental nephrology, 2021 · PMID 32816132
  11. A Phase I, Multiple-Dose, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate Pharmacokinetics, Safety, and Tolerability of Etelcalcetide Administered Intravenously to Chinese Patients With Chronic Kidney Disease Undergoing Hemodialysis.Clinical therapeutics, 2021 · PMID 34774334
  12. Randomized Trial of Etelcalcetide for Cardiac Hypertrophy in Hemodialysis.Circulation research, 2021 · PMID 33825489
  13. Comparative Effects of Etelcalcetide and Maxacalcitol on Serum Calcification Propensity in Secondary Hyperparathyroidism: A Randomized Clinical Trial.Clinical journal of the American Society of Nephrology : CJASN, 2021 · PMID 33685864
  14. A Prospective, Randomized Clinical Trial of Etelcalcetide in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism (the DUET Trial)Kidney Int Rep, 2020 · PMID 33305109
  15. [Long-term efficacy and safety of etelcalcetide in hemodialysis patients with severe secondary hyperparathyroidism].Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2020 · PMID 33026204
  16. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of working group on CKD-MBD of the Italian Society of Nephrology.Journal of nephrology, 2020 · PMID 31853791
  17. Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease.F1000Research, 2020 · PMID 32913635
  18. Comparative Effectiveness of Calcimimetic Agents for Secondary Hyperparathyroidism in Adults: A Systematic Review and Network Meta-analysis.American journal of kidney diseases : the official journal of the National Kidney Foundation, 2020 · PMID 32475604
  19. Etelcalcetide versus placebo for secondary hyperparathyroidism in patients receiving hemodialysis: A meta-analysis of randomized controlled trials.Clinical nephrology, 2020 · PMID 32729818
  20. An integrated analysis of safety and tolerability of etelcalcetide in patients receiving hemodialysis with secondary hyperparathyroidismNephrol Dial Transplant, 2019 · PMID 30875390
  21. One-year safety and efficacy of intravenous etelcalcetide in patients on hemodialysis with secondary hyperparathyroidismNephrol Dial Transplant, 2019 · PMID 30859218
  22. Etelcalcetide in Patients on Hemodialysis with Severe Secondary Hyperparathyroidism. Multicenter Study in "Real Life"J Nephrol, 2019 · PMID 31330805
  23. Administration of Etelcalcetide for the Treatment of Secondary Hyperparathyroidism in Patients with CKD-MBD on Hemodialysis: A Nephrology Nursing Perspective.Nephrology nursing journal : journal of the American Nephrology Nurses' Association, 2019 · PMID 31199098
  24. Effect of etelcalcetide on cardiac hypertrophy in hemodialysis patients: a randomized controlled trial (ETECAR-HD).Trials, 2019 · PMID 31651370
  25. Clinical Pharmacokinetics and Pharmacodynamics of Etelcalcetide, a Novel Calcimimetic for Treatment of Secondary Hyperparathyroidism in Patients With Chronic Kidney Disease on HemodialysisJ Clin Pharmacol, 2018 · PMID 29534286
  26. Managing hyperparathyroidism in hemodialysis: role of etelcalcetideTher Clin Risk Manag, 2018 · PMID 29440923
  27. Etelcalcetide (Parsabiv) for Secondary HyperparathyroidismMed Lett Drugs Ther, 2018 · PMID 29657717
  28. Population Pharmacokinetic and Pharmacodynamic Modeling of Etelcalcetide in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Receiving Hemodialysis.Clinical pharmacokinetics, 2018 · PMID 28508378
  29. [New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of Nephrologists form Lombardy].Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2018 · PMID 29786181
  30. Etelcalcetide (Parsabiv) for Secondary Hyperparathyroidism in Adults With Chronic Kidney Disease on Hemodialysis.P & T : a peer-reviewed journal for formulary management, 2018 · PMID 30013296
  31. Etelcalcetide for Treating Secondary Hyperparathyroidism: An Evidence Review Group Evaluation of a NICE Single Technology Appraisal.PharmacoEconomics, 2018 · PMID 29691773
  32. Role of etelcalcetide in the management of secondary hyperparathyroidism in hemodialysis patients: a review on current data and place in therapy.Drug design, development and therapy, 2018 · PMID 29910605
  33. Effect of Etelcalcetide vs Placebo on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism: Two Randomized Clinical TrialsJAMA, 2017 · PMID 28097355
  34. Effect of Etelcalcetide vs Cinacalcet on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism: A Randomized Clinical TrialJAMA, 2017 · PMID 28097356
  35. Long-term effects of etelcalcetide as intravenous calcimimetic therapy in hemodialysis patients with secondary hyperparathyroidismClin Nephrol, 2017 · PMID 28836058
  36. Etelcalcetide for the treatment of secondary hyperparathyroidismDrugs, 2017 · PMID 28277829
  37. A phase 3, multicentre, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of etelcalcetide (ONO-5163/AMG 416), a novel intravenous calcimimetic, for secondary hyperparathyroidism in Japanese haemodialysis patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2017 · PMID 28057872
  38. Pharmacokinetics, Biotransformation, and Excretion of [(14)C]Etelcalcetide (AMG 416) Following a Single Microtracer Intravenous Dose in Patients with Chronic Kidney Disease on Hemodialysis.Clinical pharmacokinetics, 2017 · PMID 27517676
  39. Drug disposition model of radiolabeled etelcalcetide in patients with chronic kidney disease and secondary hyperparathyroidism on hemodialysis.Journal of pharmacokinetics and pharmacodynamics, 2017 · PMID 28063122
  40. Etelcalcetide, A Novel Calcimimetic, Prevents Vascular Calcification in A Rat Model of Renal Insufficiency with Secondary Hyperparathyroidism.Calcified tissue international, 2017 · PMID 29038882
  41. Formulary Drug Review: Etelcalcetide.Hospital pharmacy, 2017 · PMID 29276237
  42. Etelcalcetide: First Global ApprovalDrugs, 2016 · PMID 27499518
  43. Nonclinical Safety Profile of Etelcalcetide, a Novel Peptide Calcimimetic for the Treatment of Secondary Hyperparathyroidism.International journal of toxicology, 2016 · PMID 26941242