QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dennis, V. C Articles by Albertson, G. L Search for Related Content PubMed PubMed Citation Articles by Dennis, V. C Articles by Albertson, G. L

FORMULARY FORUM

Doxercalciferol Treatment of Secondary Hyperparathyroidism

Assistant Professor, Department of Pharmacy Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK; Clinical Pharmacy Specialist, University of Oklahoma Family Medicine Center, Oklahoma City

Guy L Albertson, PharmD

Clinical Assistant Professor, Department of Pharmacy Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City

Reprints: Dr. Dennis, The University of Oklahoma Health Sciences Center, College of Pharmacy, 1110 N. Stonewall, Oklahoma City, OK 73190-5040, fax 405/271-6430, vincent-dennis{at}ouhsc.edu

OBJECTIVE: To review the pharmacology, pharmacokinetics, effectiveness, safety, and therapeutic considerations related to the use of doxercalciferol in the treatment of secondary hyperparathyroidism.

DATA SOURCES: A MEDLINE search (1966-June 2006) was conducted using the key words vitamin D, ergocalciferols, and secondary hyperparathyroidism. Text word searches were also performed for the terms 1--hydroxy-vitamin D₂, 1--hydroxyergocalciferol, Hectorol, and doxercalciferol. Searches were limited to studies published in English and conducted in human subjects.

STUDY SELECTION AND DATA EXTRACTION: All published clinical studies evaluating the safety and effectiveness of doxercalciferol in secondary hyperparathyroidism were reviewed, and anecdotal patient reports were also evaluated. Selected clinical studies involving the use of calcitriol and/or paricalcitol in the treatment of secondary hyperparathyroidism were also included.

DATA SYNTHESIS: Doxercalciferol effectively reduces parathyroid hormone levels in patients with chronic kidney disease (CKD). Both oral and intravenous administration can significantly increase serum calcium and/or phosphorus levels as evidenced by placebo-controlled clinical trials. This agent has not been studied comparatively with calcitriol or paricalcitol to assess relative safety.

CONCLUSIONS: Doxercalciferol is approved for and effective in the treatment of secondary hyperparathyroidism related to CKD, both before and during dialysis, but has not demonstrated a lower incidence of hypercalcemia and/or hyperphosphatemia in relation to other vitamin D therapies. The drug is available in both oral and intravenous dosage forms. Doxercalciferol should be maintained as a formulary alternative for patients unresponsive to or intolerant of other vitamin D therapies, but comparative randomized studies are needed to differentiate its place in therapy.

Key Words: doxercalciferol, chronic kidney disease, secondary hyperparathyroidism

Published Online, October 24, 2006. www.theannals.com, DOI 10.1345/aph.1G523

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-06-026-H01

This article has been cited by other articles:

				P. P. How, D. L. Mason, and A. H. Lau Current Approaches in the Treatment of Chronic Kidney Disease Mineral and Bone Disorder Journal of Pharmacy Practice, June 1, 2008; 21(3): 196 - 213. [Abstract] [PDF]