Comparison of Paricalcitol (I.V) and Alfacalcidol (I.V) in Treatment of Secondary Hyperparathyroidism (SHPT) in Hemodialysis Patients

• Main Authors: Mansoor Abbas Qaisar, Zain ul Abideen, Fateh Sher Chattah, Muhammad Nadeem, Zahid Hafeez
• Format: Article
• Language: English
• Published: Rawalpindi Medical University 2020-12-01
• Series: Journal of Rawalpindi Medical College
• Subjects: Alfacalcidol, Paricalcitol, Secondary hyperparathyroidism, Hemodialysis.
• Online Access: https://www.journalrmc.com/index.php/JRMC/article/view/1468
• ISSN: 1683-3562; 1683-3570

ABSTRACT   Objective of study: To Compare the efficacy of Alfacalcidol (I.V) and Paricalcitol (I.V) for the treatment of secondary hyperparathyroidism  (SHPT)  in hemodialysis patients. Materials and Methods: An open-label randomized clinical trial  carried out to compare the efficacy of intravenous paricalcitol and alfacalcidol. We recruited 80 patients with end stage renal  disease receiving  maintenance hemodialysis in a tertiary care hospital dialysis unit. The participants were randomly divided into two  groups. A wash out period of one week was decided for each patient in which he/she did not receive any medication for treatment of hypocalcemia, hyperphosphatemia or secondary hyperparathyroidism. Afterwards, patients  received  expanding dosage of alfacalcidol or paricalcitol  for a time of about four months and then after a further wash out period of one week, each group received  opposite treatment (paricalcitol or alfacalcidol) for further  four months (16 weeks). Results: The analyzed data for the same end points revealed no difference between the two groups. No significant statistical difference in terms of  calcium levels in both groups was noted. The study also found no big difference  in the ability of both drugs to treat secondary hyperparathyroidism, while keeping serum phosphate and calcium levels inside the desired range. The study also found no distinction in the frequency of hypercalcemia and  hyperphosphatemia as a side effect of Vitamin D analogue’s treatment.   Conclusion: The study concludes that alfacalcidol and paricalcitol are equally effective in treatment of secondary hyperparathyroidism in dialysis population. Since Paricalcitol is expensive as compared to alfacalcidol, in an economically challenged country like Pakistan, Alfacalcidol can be a better  choice when treating SHPT as we did not  find any gross difference in the ability of two drugs to restrict SHPT.   Keywords:  Alfacalcidol, Paricalcitol, Secondary hyperparathyroidism, Hemodialysis.