Parsabiv

Parsabiv, the brand name for etelcalcetide, is a synthetic peptide calcimimetic indicated for the treatment of secondary hyperparathyroidism in adults with chronic kidney disease on maintenance hemodialysis. It was developed by Amgen and received U.S. FDA approval in 2016, with subsequent regulatory approvals in other regions. The drug is administered intravenously after hemodialysis sessions.

Etelcalcetide acts by binding to and increasing the sensitivity of the calcium-sensing receptor on the parathyroid gland, leading to reduced secretion of parathyroid hormone (PTH). By lowering PTH, the drug can help reduce associated abnormalities of mineral metabolism in dialysis patients, including impacts on calcium and phosphate balance.

Parsabiv is given as an intravenous infusion after each dialysis session, with dosing individualized and titrated every 2-4 weeks based on iPTH and serum calcium levels. The starting dose is commonly 5 mg per dialysis session, with adjustments made to achieve target PTH ranges while avoiding hypocalcemia. Treatment is typically administered three times weekly in line with dialysis schedules.

Common adverse effects include hypocalcemia, nausea, vomiting, muscle spasms, and headache. Hypocalcemia is a key safety concern and requires regular monitoring of serum calcium and electrolyte status, with dose adjustments or temporary discontinuation if calcium levels fall too low. Clinicians monitor mineral metabolism markers to balance PTH suppression with maintenance of mineral homeostasis.