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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 effect32 studies

Studies that measured serum calcium

and 29 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 effect30 studies

Studies that measured serum phosphorus

and 27 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 effect29 studies

Studies that measured pth reduction

and 26 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 effect29 studies

Studies that measured pth target achievement

and 26 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 effect28 studies

Studies that measured fgf23 levels

and 25 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

32 studies from PubMed

  1. The calcium-sensing receptor: a comprehensive review on its role in calcium homeostasis and therapeutic implications.American journal of translational research, 2025 · PMID 40226019
  2. 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
  3. 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
  4. Cardio-renal interaction - Clinical trials update 2022.Nutrition, metabolism, and cardiovascular diseases : NMCD, 2022 · PMID 36064690
  5. 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
  6. Etelcalcetide versus placebo for secondary hyperparathyroidism in patients receiving hemodialysis: A meta-analysis of randomized controlled trials.Clinical nephrology, 2020 · PMID 32729818
  7. 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
  8. A Prospective, Randomized Clinical Trial of Etelcalcetide in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism (the DUET Trial)Kidney Int Rep, 2020 · PMID 33305109
  9. Etelcalcetide in Patients on Hemodialysis with Severe Secondary Hyperparathyroidism. Multicenter Study in "Real Life"J Nephrol, 2019 · PMID 31330805
  10. One-year safety and efficacy of intravenous etelcalcetide in patients on hemodialysis with secondary hyperparathyroidismNephrol Dial Transplant, 2019 · PMID 30859218
  11. An integrated analysis of safety and tolerability of etelcalcetide in patients receiving hemodialysis with secondary hyperparathyroidismNephrol Dial Transplant, 2019 · PMID 30875390
  12. 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
  13. Etelcalcetide for Treating Secondary Hyperparathyroidism: An Evidence Review Group Evaluation of a NICE Single Technology Appraisal.PharmacoEconomics, 2018 · PMID 29691773
  14. Managing hyperparathyroidism in hemodialysis: role of etelcalcetideTher Clin Risk Manag, 2018 · PMID 29440923
  15. 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
  16. Formulary Drug Review: Etelcalcetide.Hospital pharmacy, 2017 · PMID 29276237
  17. Etelcalcetide for the treatment of secondary hyperparathyroidismDrugs, 2017 · PMID 28277829
  18. Long-term effects of etelcalcetide as intravenous calcimimetic therapy in hemodialysis patients with secondary hyperparathyroidismClin Nephrol, 2017 · PMID 28836058
  19. Effect of Etelcalcetide vs Cinacalcet on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism: A Randomized Clinical TrialJAMA, 2017 · PMID 28097356
  20. Effect of Etelcalcetide vs Placebo on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism: Two Randomized Clinical TrialsJAMA, 2017 · PMID 28097355
  21. Effects of tocotrienol supplementation on hair growth in human volunteersTrop Life Sci Res · PMID 24575202
  22. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year studyInt J Immunopathol Pharmacol · PMID 23298508
  23. Randomized Clinical Trial to Evaluate the Effect of Probiotic Intake on Androgenic Alopecia.Nutrients · PMID 39275216
  24. Effect of applying Lactiplantibacillus plantarum subsp. plantarum N793 to the scalps of men and women with thinning hair: a randomized, double-blind, placebo-controlled, parallel-group study.Biosci Microbiota Food Health · PMID 38966052
  25. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in menJ Am Acad Dermatol · PMID 12196747
  26. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair lossJ Am Acad Dermatol · PMID 15034503
  27. Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese menJ Dermatol · PMID 19691748
  28. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in menJ Am Acad Dermatol · PMID 17761356
  29. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in womenJ Am Acad Dermatol · PMID 21700360
  30. Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatmentJ Am Acad Dermatol · PMID 10534633
  31. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopeciaDermatology · PMID 15316165
  32. The effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a randomized controlled trialBr J Dermatol · PMID 12932243