Upacicalcet: A Novel Intravenous Calcimimetic Agent for Patients Undergoing Hemodialysis With Secondary Hyperparathyroidism

Secondary hyperparathyroidism (SHPT) is a common complication in patients receiving maintenance dialysis, driven by calcium and phosphate metabolism disturbances. Calcimimetics are central to the management of SHPT by enhancing calcium‐sensing receptor sensitivity and reducing parathyroid hormone secretion. Upacicalcet is a novel intravenous calcimimetic that was specifically developed for hemodialysis patients. It is efficiently removed by hemodialysis, does not undergo hepatic metabolism, and has minimal potential for drug–drug interactions. Clinical studies have shown that upacicalcet effectively lowers serum intact parathyroid hormone and improves associated biochemical markers such as fibroblast growth factor‐23 and bone turnover indices. It demonstrates a low incidence of gastrointestinal symptoms and hypocalcemia. Upacicalcet achieves sustained biochemical control with good tolerability in long‐term use. These features suggest that upacicalcet is a safe and ideal option for the long‐term management of SHPT in patients undergoing hemodialysis.