Abstract
A unique analogue of vitamin D3 (Vit D3), 22-oxacalcitriol (OCT), has a significant suppressive effect on the parathyroid gland and reduced calcemic action compared to calcitriol. An OCT trial was performed over 26 weeks in 14 hemodialysis patients with secondary hyperparathyroidism (2° HPT), of whom 10 cases were refractory for oral Vit D3 pulse therapy to assess the usefulness of this therapy.
Excellent reduction greater than 50% of the initial value of intact parathyroid hormone (i-PTH) was obtained in 5 cases (35.7%) and moderate reduction from 30 to 50% of the initial value of i-PTH in 4 cases (28.6%). In addition, improvement of the subjective symptom (pruritus, bone and joint pain) was noted in 7 cases (53.8%). No side effects such as hypercalcemia were found during the trial term.
Thus, this study showed a practical benefit of OCT in the treatment of 2° HPT and a potential advantage over the conventional oral Vit D3 pulse therapy.
