Calcimimetic Drugs and Biomarkers
Hansjorg Rothe, Orfeas Liangos, Arndt Petermann, Patrick Biggar and Markus Ketteler
Affiliation: Klinikum Coburg, III. Medical Department, Division of Nephrology and Hypertension, Ketschendorfer Strasse 33, D-96450 Coburg, Germany.
Keywords: Biomarkers, calcimimetics, calcium, calcium-sensing receptor, cinacalcet HCl, end-stage kidney disease, FGF-23,
hyperparathyroidism, parathormone, pharmacogenetics, phosphorus, polymorphism, velcalcetide.
The calcium-sensing receptor is expressed almost ubiquitously throughout the human body, and is essential for
calcium homeostasis and is involved in several disease pathomechanisms. Mainly in nephrology, therapeutic compounds
acting on the receptor are already in use in clinical routine practice. The era of calcimimetic therapy, which commenced
10 years ago with the approval of the first-in-class compound cinacalcet HCl, has recently entered into a new phase with
the arrival of velcalcetide (AMG416). Since both compounds bind to different sites at the receptor molecule, genetic
polymorphism panels could conceivably play a role in future for the prediction of the best choice for any given patient. If velcalcetide,
which has currently just passed phase-III-trials, is also approved for therapeutic use, this will increase the spectrum
of choices and the clinician will have to make decisions about which calcimimetic drug to give to which patient. This decision
would probably have to be based on various considerations including biomarkers. This article summarizes the present
situation regarding patents on biomarkers dealing with the calcium-sensing receptor and genetic polymorphisms.
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