Upacicalcet reduces PTH in secondary hyperparathyroidism trials

Phase 3 PATH-1 and PATH-2 clinical trials have demonstrated that upacicalcet, an investigational intravenous calcimimetic, significantly reduces intact parathyroid hormone (iPTH) in patients undergoing hemodialysis for secondary hyperparathyroidism (SHPT).

Results presented by Jessica Kendrick, MD, MPH, at ASN Kidney Week 2026 indicate that upacicalcet increased the proportion of patients achieving at least a 30% reduction in iPTH compared to a placebo. The trials involved 768 patients with baseline iPTH levels between 400 and 1500 pg/mL.

Unlike existing calcimimetics, which are often limited by gastrointestinal side effects and hypocalcemia, upacicalcet acts as a positive allosteric modulator of the calcium-sensing receptor. It functions only when extracellular calcium levels are at a physiologic level. While already approved for SHPT in Japan, Pathalys Pharma is currently developing the agent for potential regulatory submission in the United States.