Methods and compositions for reducing parathyroid levels
Methods and compositions for reducing serum parathyroid levels in, for example, chronic kidney disease patients are disclosed. In these methods, an effective amount of a modified release formulation of 25-hydroxy vitamin D is orally administered to a patient suffering from secondary hyperparathyroidism to lower the patient's serum intact parathyroid hormone (iPTH) level, while avoiding a surge in serum total 25-hydroxy vitamin D.
1. A method of treating secondary hyperparathyroidism, comprising orally administering to an adult human patient suffering from secondary hyperparathyroidism a sustained release dosage form comprising 25-hydroxyvitamin D 3 , in a dosage amount of 900 μg per week, providing a rise in serum total 25-hydroxyvitamin D of at least 7 ng/ml and no greater than 30 ng/ml within the first 24 hours after said administering, and said administering providing a rise in serum total 1,25-dihydroxyvitamin D of greater than 3 pg/mL and less than 10 pg/mL within the first 24 hours after said administering, wherein the rise in serum total 1,25-dihydroxyvitamin D is sustained for at least 48 hours following said administering, and lowering the patient's serum intact parathyroid hormone (iPTH) level.
2. The method of claim 1 , wherein the T max of serum total 25-hydroxyvitamin D following said administering step is at least 4 hours.
3. The method of claim 2 , wherein the T max of serum total 25-hydroxyvitamin D following said administering step is at least 12 hours.
4. The method of claim 1 , wherein the patient also suffers from vitamin D insufficiency or deficiency, as defined by serum total 25-hydroxyvitamin D of less than 30 ng/ml.
5. The method of claim 1 , comprising administering the sustained release dosage form on a frequency of every other day or less.
6. The method of claim 1 , wherein the patient's iPTH level is lowered by at least 10% compared to baseline.
7. The method of claim 6 , wherein the patient's iPTH level is lowered by at least 15% compared to baseline.
8. The method of claim 1 , wherein the patient's iPTH level remains lowered for at least 96 hours.
9. The method of claim 1 , wherein the patient suffers from hyperparathyroidism secondary to chronic kidney disease (CKD).
10. The method of claim 9 , wherein said CKD is Stage 2, Stage 3, Stage 4, or Stage 5 CKD.
11. The method of claim 10 , wherein said CKD is Stage 3 or Stage 4.