cinacalcet HCl / Generic mfg. - LARVOL DELTA

LONG-TERM DYNAMICS OF CKD-MBD PARAMETERS AFTER PARATHYROIDECTOMY AND SURVIVAL IN DIALYSIS PATIENTS (ISN-WCN 2026) - "Cinacalcet was administered to 37% of patients at averaged dose (SD) of 48 (24) mg/day.Subtotal PTX was performed on 34% of patients and total PTX with autotransplantation of parathyroid gland tissue, was performed on 66% of patients.The baseline levels of calcium, ionized calcium, phosphate, parathyroid hormone (PTH), and alkaline phosphatase were 2.45 (0.23) mmol/L, 1.02 (0.04) mmol/L, 1.98 (0.51) mmol/L, 134 pmol/L [95-204], and 220 [160-471] IU, respectively...Of them, long-term trends in PTH (OR=1.41 [95% CI 1.026 - 1.938], p=0.034) and serum phosphorus (OR=1.162 [95% CI 1.03 - 1.31], p=0.014) were independent predictors of all-cause mortality (Tab.1).Download: Download high-res image (107KB)Download: Download full-size imageConclusion The long-term effect of parathyroidectomy (PTX) on hard endpoints is influenced by the future trajectory of mineral and bone disease parameters. Physicians should consider this when making a prognosis and planning the extent of the..."

Clinical • Chronic Kidney Disease • Endocrine Disorders • Orthopedics • Secondary Hyperparathyroidism

THE EFFECT OF ETELCALCETIDE ON UNCONTROLLED SECONDARY HYPERPARATHYROIDISM AMONG HEMODIALYSIS PATIENTS- SINGLE CENTRE EXPERIENCE. (ISN-WCN 2026) - "Many dialysis patients have uncontrolled hyperparathyroidism despite using Calcium supplements, vitamin D analogs & oral calcimimetics (Cinacalcet). Phosphorus level (mmol/L) during different study stages.Phosphorus level (mmol/l)StartAfter 6 monthsSep. 2025Phosphorus 3.0211Patient number463645Phosphorus 3.04.35%2.78%2.22%Conclusion 1) Etelcalcetide is a safe and well tolerated novel treatment for challenging secondary hyperparathyroidism cases among hemodialysis patients.2) Etelcalcetide is a very effective treatment for controlling iPTH.3) Secondary hyperparathyroidism control can be achieved with well balanced and patient specific treatment regimens including Etelcalcetide.4) Medication compliance and concordance can be improved significantly with IV Etelcalcetide treatment on dialysis for many patients."

Clinical • Chronic Kidney Disease • Endocrine Disorders • Nephrology • Renal Disease • Secondary Hyperparathyroidism

REGRESSION OF UREMIC TUMORAL CALCINOSIS FOLLOWING ETELCALCETIDE THERAPY IN HEMODIALYSIS PATIENTS (ISN-WCN 2026) - "At that time, he was receiving cinacalcet hydrochloride and lanthanum carbonate.Results We considered his intact PTH level was potentially underestimated, because blood sampling had been performed several hours after cinacalcet administration. Etelcalcetide has been reported to produce more sustained reductions in serum calcium and PTH levels than cinacalcet in hemodialysis patients, and this pharmacological property may contribute to the dissolution of calcified deposits. Our experience suggests that intravenous etelcalcetide therapy could represent a valuable therapeutic option for uremic tumoral calcinosis in selected patients, potentially expanding current management strategies beyond conventional approaches focused solely on calcium-phosphate control."

Clinical • Endocrine Disorders • Metabolic Disorders • Musculoskeletal Diseases • Nephrology • Oncology • Orthopedics • Renal Disease

CASE OF SEVERE HYPERCALCEMIA DUE TO PARATHYROID ADENOMA IN A YOUNG FEMALE PRESENTING WITH ACUTE PANCREATITIS AND ACUTE KIDNEY INJURY- CASE REPORT. (ISN-WCN 2026) - "In view of severe hypercalcemia, she was started on IV steroids, subcutaneous calcitonin (200 U s/c bid), cinacalcet (30mg bid) and volume expansion with fluids...Calcium free dialysis proves favorable adjunct for rapidly correcting severe hypercalcemia with life threatening cardiac complication, renal failure or any other manifestation that contradicts intravenous hydration.Early diagnosis and prompt treatment of hypercalcemic crisis due to parathyroid storm by calcium free/ low calcium dialysate hemodialysis is effective and helps to control severe hypercalcemia early and prevents acute life-threatening complications. Medical therapy should be followed by urgent parathyroidectomy which remains a cornerstone of management in hypercalcemic crisis due to PHPT{13}."

Case report • Clinical • Acute Kidney Injury • Acute Respiratory Distress Syndrome • Cardiovascular • CNS Disorders • Endocrine Disorders • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Pancreatitis • Renal Calculi • Renal Disease • Respiratory Diseases • CRP • MUC16

Amyloid-β as a target to suppress tonic PTH hypersecretion in hyperparathyroidism due to vitamin D deficiency. (PubMed, Sci Transl Med) - "Likewise, weekly administration of an amyloid-β-neutralizing antibody suppressed tonic PTH hypersecretion and synergized with daily administration of cinacalcet, which activates CaSR homodimers, to reduce serum PTH concentrations in aged mice. These data demonstrated amyloid-β actions in driving tonic PTH secretion by activating GABAB1R/CaSR heterodimers and the potential of targeting amyloid-β to treat hyperparathyroidism due to vitamin D deficiency."

Journal • Endocrine Disorders • APP • CASR • MAPT

Coupling MgSO4-assisted SALLE with a fluorimetric turn-off strategy for the determination of cinacalcet HCl in pharmaceutical and human matrices. (PubMed, Sci Rep) - "Sustainability assessment using the WAC framework categorized the platform as "white," highlighting low environmental impact, safe operation, and simplicity. By minimizing organic solvent use and eliminating hazardous reagents, this MgSO₄-assisted SALLE/fluorescence turn-off approach provides a green, highly sensitive, and versatile tool for trace-level determination of Cinacalcet HCl in pharmaceutical and biological matrices."

Journal

Calcium-Phosphate Nephrocalcinosis and Progressive CKD in X-Linked Hypophosphatemia: Consequences of Lifelong Phosphate and Calcitriol Therapy (NKF-SCM 2026) - "She had congenital hypophosphatemic rickets, treated with calcium, phosphate, and calcitriol; nephrolithiasis managed with lithotripsy; hypertension on losartan; and parathyroidectomy for primary hyperparathyroidism (calcium 11.4 mg/dL, PTH 10 pg/mL)...She continues follow-up for stable stage 4 CKD due to calcium-phosphate nephrocalcinosis, managed with cinacalcet, calcitriol, and phosphate...Conventional therapy often causes nephrocalcinosis and progressive CKD. Burosumab, an anti-FGF23 monoclonal antibody, restores phosphate homeostasis and improves bone mineralization and clinical outcomes including a lower risk of nephrocalcinosis."

Cardiovascular • Chronic Kidney Disease • Endocrine Disorders • Hypertension • Metabolic Disorders • Nephrology • Renal Calculi • Renal Disease • FGF23

Evaluating calcimimetic use: An audit of two UK renal centres (UKKW 2026) - "Results Centre 1 - 69 patients (17% of HD population) were identified; 48/69 (70%) were prescribed Cinacalcet and 21/69 (30%) Etelcalcetide. Given the burden of symptoms, the costs, and the tablet burden associated with SHPT, ensuring effective prescribing is key. Findings highlight a need for prescribing protocols to guide management and improve the clinical safety and effectiveness of calcimimetics."

Cardiovascular • Chronic Kidney Disease • Endocrine Disorders • Musculoskeletal Diseases • Nephrology • Orthopedics • Secondary Hyperparathyroidism

Preferred but Restricted: Impact of the End Stage Renal Disease Bundle on Dialysis Treatment (NKF-SCM 2026) - "One example of this phenomenon is in etelcalcetide patient share, which is expected to stabilize near 12% among calcimimetic-treated HD patients with no recovery anticipated, while cinacalcet continues to dominate calcimimetic use. CONCLUSION US-based nephrologists describe a pronounced gap between their preferred use of medications for their ESRD patients and what they can realistically deliver under the ESRD bundle, with administrative barriers driving use of various agents down despite interest in them. These findings indicate that the central challenge is not awareness or clinical interest, but bundle-driven restrictions and center-level protocols and highlight clear opportunities to refine access strategies to align with physicians’ clinical priorities."

Chronic Kidney Disease • Nephrology • Renal Disease

In Vitro Analysis of Effects of Upacicalcet, Cinacalcet, and Etelcalcetide on the Calcium Sensing Receptor (CaSR) (NKF-SCM 2026) - "The distinct in vitro activation profiles of upacicalcet, cinacalcet, and etelcalcetide may translate to differences in clinical outcomes, particularly regarding risk of hypocalcemia and potentially gastrointestinal adverse effects. Further clinical studies are warranted to confirm whether these in vitro differences in CaSR activation are associated with differentiated safety and efficacy profiles in hemodialysis patients with SHPT."

Preclinical • Endocrine Disorders • Renal Disease • Secondary Hyperparathyroidism

Breast Calciphylaxis Mimicking Malignancy in a Renal Transplant Recipient: Recovery After Warfarin Discontinuation (NKF-SCM 2026) - "Warfarin was replaced with apixaban, calcitriol was discontinued, cinacalcet was continued, and supportive wound care was provided. RESULTS/CASE DISCUSSION CUA of brea is a rare post-transplant complication that can mimic cancer. Diagnosis requires biopsy, systemic calcification should be evaluated, and adjusting anticoagulation, especially stopping warfarin, can improve outcomes."

Clinical • Breast Cancer • Calciphylaxis • Chronic Kidney Disease • Immunology • Inflammatory Arthritis • Lupus • Nephrology • Obesity • Oncology • Rare Diseases • Solid Tumor • Systemic Lupus Erythematosus • Thrombosis • Transplantation

Supramolecular protecting groups can impart prosthetic stereoselectivity to catalytic systems employing unmodified achiral heterogenous catalysts. (PubMed, Chem Sci) - "Since this non-covalent analogue to conventional covalent protecting group strategies is modular, the same substrate/host combination may be applied to a range of catalytic surfaces. The potential of this approach to achieve effective kinetic resolution is demonstrated in stereoselective synthesis of the drug (R)-cinacalcet."

Journal

Metastatic hypercalcemia from laxative misuse: a rare and serious complication of anorexia nervosa. (PubMed, JCEM Case Rep) - "Treatment with cinacalcet resulted in biochemical improvement. This case highlights the complex and multifactorial mechanisms of hypercalcemia in AN, in which covert laxative misuse, renal dysfunction, and disordered phosphate and PTH regulation culminate in life-threatening metastatic calcification."

Journal • Anorexia • Chronic Kidney Disease • Endocrine Disorders • Metabolic Disorders • Nephrology • Pain • Renal Disease

Evocalcet improved the PTH-calcium setpoint and suppressed parathyroid proliferation in mice model of primary hyperparathyroidism. (PubMed, J Bone Miner Metab) - "Evocalcet, similar to cinacalcet, lowers the PTH-calcium setpoint and inhibits parathyroid cell proliferation in a mouse model of primary hyperparathyroidism. These findings suggest that evocalcet may not only reduce PTH secretion but also attenuate disease progression in hyperparathyroidism."

Journal • Preclinical • Endocrine Disorders • Secondary Hyperparathyroidism • CASR • CCND1 • VDR

Distinguishing AP2S1 Mediated Familial Hypocalciuric Hypercalcemia from Primary Hyperparathyroidism Helps Clarify Familial Hypercalcemia and Avoid Unnecessary Surgery (ACMG 2026) - "Treatment with cinacalcet, a calcium-sensing receptor activator, can reduce serum calcium and has been tried in patients with symptoms attributed to hypercalcemia...Conclusion Heterozygous pathogenic variants in AP2S1 are a rare cause of FHH and identification of a genetic cause has significant prognostic and therapeutic value. All disease-causing variants identified so far are amino acid substitutions at position 15, suggesting that a missense variant at this critical residue has a dominant negative effect on the normal AP2S1 copy."

Surgery • Constipation • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Metabolic Disorders • Nephrology • Osteoporosis • Renal Calculi • Rheumatology • ARG1 • CASR • CDC73 • GNA11 • TRPV6

THE CHILLING EFFECTS OF THE UNKNOWN: CALCIPHYLAXIS (WRMC 2026) - "[1][4] Female sex, obesity, diabetes, secondary hyperparathyroidism, vitamin K deficiency, corticosteroid or warfarin use, hypoalbuminemia, and systemic inflammatory or autoimmune disorders are risk factors...Also, nephrology ordered sevelamer, sodium thiosulfate IV post-hemodialysis, and cinacalcet...The study of calciphylaxis requires an emphasis on better approaches for prevention, early diagnosis, management, and quality of life improvement. [1][5][8] IMAGE 1: Calciphylaxis"

Acute Kidney Injury • Calciphylaxis • Cardiovascular • Chronic Kidney Disease • Dermatology • Diabetes • Diabetic Nephropathy • Dyslipidemia • Endocrine Disorders • Genetic Disorders • Hematological Disorders • Hypertension • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Obesity • Palliative care • Rare Diseases • Renal Disease • Secondary Hyperparathyroidism • Septic Shock • Thrombosis

Stereoconvergent Photo-Biocatalytic Cascade to Optically Enriched Amines from Racemic Carboxylic Acids. (PubMed, ACS Omega) - "Among the tested substrates, three representative nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, flurbiprofen, and naproxen, were successfully transformed into dehomologated NSAID-derived nonracemic amines with 62->99% ee, respectively. Furthermore, upscaling of the photobiocatalytic process employing 2-(naphthalen-1-yl)-propanoic acid (1.0 mmol) as the substrate enabled the synthesis of (R)-1-(naphthalen-1-yl)-ethan-1-amine with 92% product formation and >99% ee. Finally, a one-step transformation of the aforementioned amine using a recently developed betaine-based Mitsunobu reagent furnished the enantiomerically pure calcimimetic drug cinacalcet (>99% ee) in 76% isolated yield, without the need for transition metal catalysts and/or hazardous and flammable hydrogen gas."

Journal

Switching patients from cinacalcet to etelcalcetide: evaluation of predictors of efficacy in a retrospective cohort study (PubMed, Probl Endokrinol (Mosk)) - "In moderate SHPT (PTH 600-1000 pg/ml) it is possible to achieve the target in most patients, but with higher level, the result worsened. The signs of parathyroid authonomy predicts the insufficient effect better than high baseline PTH level."

Journal • Retrospective data • Renal Disease • Secondary Hyperparathyroidism

Cinacalcet Efficacy in Hyperparathyroidism-Chronic Kidney Disease-Non-Dialysis, Hemodialysis, Peritoneal Dialysis, Kidney Transplantation: Critical Review. (PubMed, Biomedicines) - "In kidney transplant recipients, parathyroidectomy achieved greater normalization of PTH and calcium. Cinacalcet has been shown to reduce mortality in patients on hemodialysis and peritoneal dialysis."

Journal • Review • Cardiovascular • Chronic Kidney Disease • Endocrine Disorders • Musculoskeletal Diseases • Nephrology • Orthopedics • Osteoporosis • Renal Disease • Transplantation

Minimal Physiologically-Based Pharmacokinetic Modeling to Predict Concentration-Time Profiles of Poorly Soluble Cinacalcet Hydrochloride in Fasting and Fed State. (PubMed, Eur J Drug Metab Pharmacokinet) - "The mPBPK model can accurately predict the plasma concentration-time curves under both fasted and fed conditions, and provides a new perspective for establishing in vivo-in vitro correlations of drug products such as incomplete in vivo release, sustained/controlled release, and poor absorption."

Journal • PK/PD data

Comparative effectiveness of parathyroidectomy versus cinacalcet in severe secondary hyperparathyroidism among hemodialysis patients in Sudan: a retrospective cohort study. (PubMed, BMC Nephrol) - No abstract available

HEOR • Journal • Retrospective data • Chronic Kidney Disease • Endocrine Disorders • Renal Disease • Secondary Hyperparathyroidism

Cinacalcet therapy in symptomatic 11-year-old girl with familial hypocalciuric hypercalcemia type 3. (PubMed, Pediatr Nephrol) - "After a dose titration and vitamin D3 dose adjustments, a normalization of serum calcium and PTH was achieved, and symptoms improved substantially, although lumbar bone mineral density declined further, and neurological symptoms remained. This case demonstrates cinacalcet as an effective and well-tolerated therapy in FHH3, with unresolved questions regarding skeletal and neurocognitive outcomes."

Journal • Cognitive Disorders • Endocrine Disorders • Genetic Disorders • Metabolic Disorders • Rare Diseases • CASR

SHR6508-301: The Trial of SHR6508 in Secondary Hyperparathyroidism (clinicaltrials.gov) - P3 | N=498 | Completed | Sponsor: Shanghai Hengrui Pharmaceutical Co., Ltd. | Active, not recruiting ➔ Completed

Trial completion • Endocrine Disorders • Secondary Hyperparathyroidism

Management of Neonatal Severe Hyperparathyroidism due to Homozygous CASR Mutation: Challenges and Literature Insights. (PubMed, Mol Syndromol) - "Despite initial treatment with hydration and furosemide, her hypercalcemia persisted. Cinacalcet was started but failed to control calcium levels, leading to the need for a subtotal parathyroidectomy at 2.5 months of age...Postoperatively, the patient developed hypocalcemia due to hungry bone syndrome and later experienced recurrent hypercalcemia, which was managed with pamidronate followed by calcitriol...Subtotal parathyroidectomy proved essential for controlling hypercalcemia. Continued documentation of NSHPT cases will help improve treatment strategies and outcomes for this rare condition."

Journal • Endocrine Disorders • Metabolic Disorders • CASR

Cinacalcet Perturbs Membrane Permeability of bEND.3 Endothelial Cells and Suppresses Cell Proliferation. (PubMed, Physiol Res) - "These data suggest cinacalcet, in a manner independent of CaSR stimulation and membrane fluidity perturbation, caused membrane leakiness, eventually leading to inhibition of EC proliferation and EC death. Key words Ca2+-sensing receptors " Endothelium " Cinacalcet " Ca2+ " Membrane permeability."

Journal • Oncology