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Hormones & reproductionCalcimimetic peptide

Etelcalcetide

Also known as: Parsabiv, AMG416, Velcalcetide

By the Peptide Dossier Editorial TeamUpdated How we source

Etelcalcetide is an IV peptide calcimimetic used to lower PTH in adults on hemodialysis. It suppresses excessive parathyroid signaling rather than replacing missing hormone.

Quick Facts

Class:Calcimimetic peptide
US product context:FDA-approved for adult dialysis-associated secondary hyperparathyroidism.
Evidence context:Head-to-head randomized PTH-lowering evidence versus oral cinacalcet in hemodialysis.

Identity and dialysis context

Etelcalcetide, developed as AMG416/velcalcetide and marketed as Parsabiv, is a synthetic peptide calcimimetic. Secondary hyperparathyroidism in advanced kidney disease makes the parathyroid glands overactive; this drug makes their calcium-sensing system respond as though calcium is adequate. US approval was in 2017.

Calcium-sensing receptor and comparative trial

Activation of the parathyroid calcium-sensing receptor increases sensitivity to calcium and lowers PTH secretion. This reduces excessive calcium/phosphate turnover contributing to dialysis-related bone and cardiovascular problems. It is the opposite of PTH replacement.

IV delivery through the dialysis circuit avoids reliance on a daily tablet. In a randomized head-to-head study it lowered PTH at least as well as oral cinacalcet, with more patients reaching large reductions. The exposure route may support adherence but does not remove monitoring needs.

Sources: [1]

Approved use and schedule

FDA approved Parsabiv in 2017 for secondary hyperparathyroidism in adults with CKD on hemodialysis. A bolus is given at the end of dialysis, three times weekly. It is not recommended for primary hyperparathyroidism or CKD patients who are not on dialysis.

Sources: [2]

Adverse effects and calcium risk

Common effects are low calcium, muscle spasms, nausea, vomiting, diarrhea and headache. Severe hypocalcemia can cause seizures or rhythm disturbances, so calcium is monitored. Worsened heart failure in some patients and upper gastrointestinal bleeding are further important concerns.

References and further reading

This reference draws on Superpower’s Peptide Library and the research linked below. Peptide Dossier’s editorial team adapted and integrated the material on .

  1. 10.1001/jama.2016.19468Calcium-sensing receptor and comparative trialCited in: Calcium-sensing receptor and comparative trial
  2. pi.amgen.comApproved use and scheduleCited in: Approved use and schedule

Frequently Asked Questions About Etelcalcetide

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Disclaimer: This article is for informational and educational purposes only. It is not intended as medical advice. The information presented is based on published research and should not be used as a substitute for professional medical guidance. Always consult a qualified healthcare provider before starting any peptide protocol. Some peptides discussed may not be approved for human use by the FDA or equivalent regulatory bodies.