Cinacalcet as alternative treatment for primary hyperparathyroidism: achievements and prospects

Endocrine. 2011 Jun;39(3):199-204. doi: 10.1007/s12020-011-9452-7. Epub 2011 Mar 26.


Primary hyperparathyroidism (pHPT), which most frequently occurs asymptomatically, is a common endocrine disease associated with increased morbidity and mortality. The newly introduced management guidelines as well as the recent availability of the first calcimimetic offer a highly promising therapeutic option for patients with pHPT. Cinacalcet, the first available calcimimetic, increases the sensitivity of the calcium-sensing receptor (CaR) to circulating serum calcium, thereby safely reducing serum calcium and PTH concentrations in patients with mild-to-moderate pHPT, intractable disease, and also parathyroid carcinoma. Cinacalcet has proved efficient in short- and long-term controls of hypercalcemia and, though bone mineral density was not improved, the available data point to cinacalcet as the treatment of choice in non-operable patients with pHPT. These results encompass a wide spectrum of disease severity. Results are pending as to whether cinacalcet decreases mortality and morbidity in pHPT, confirmation of which would conclusively recommend this drug as a valid alternative to surgery.

Publication types

  • Review

MeSH terms

  • Calcimimetic Agents / therapeutic use
  • Cinacalcet
  • Contraindications
  • Diphosphonates / therapeutic use
  • Endocrine Surgical Procedures
  • Humans
  • Hyperparathyroidism, Primary / drug therapy*
  • Hyperparathyroidism, Primary / mortality
  • Hyperparathyroidism, Primary / surgery
  • Naphthalenes / adverse effects
  • Naphthalenes / therapeutic use*
  • Selective Estrogen Receptor Modulators / therapeutic use


  • Calcimimetic Agents
  • Diphosphonates
  • Naphthalenes
  • Selective Estrogen Receptor Modulators
  • Cinacalcet