Method of treating and preventing secondary hyperparathyroidism

A - Human Necessities – 61 – K

Patent

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A61K 31/59 (2006.01) A61P 5/20 (2006.01)

Patent

CA 2655499

A method of treating elevated blood levels of iPTH by increasing or maintaining blood concentrations of both 25 -hydroxy vitamin D and 1, 25-dihydroxyvitamin D in a patient by administering, as necessary, both Vitamin D repletion and Vitamin D hormone replacement therapies, is disclosed. The blood concentrations of 25 -hydroxy vitamin D are increased to and maintained at or above 30 ng/mL, and blood concentrations of 1, 25-dihydroxyvitamin D are increased to or maintained within a patient's normal historical physiological range for 1, 25-dihydroxyvitamin D without causing substantially increased risk of hypercalcemia, hyperphosphatemia or over suppression of plasma iPTH in the patient. The blood levels of 25- hydroxyvitamin D are maintained at or above 30 ng/mL between doses of Vitamin D repletion therapies, and the blood levels of 1, 25-dihydroxyvitamin D are maintained in the patient's normal historical physiological range between doses of Vitamin D hormone replacement therapies. In one aspect, the disclosure includes methods wherein the blood concentration of 25- hydroxyvitamin D during treatment comprises predominantly 25 -hydroxy vitamin D3, and/or wherein the method includes administering predominantly or solely 25-hydroxyvitamin D3 for 25 -hydroxy vitamin D repletion and/or maintenance

L'invention concerne un procédé de traitement d'une élévation anormale des taux sanguins d'iPTH en augmentant ou en maintenant des concentrations sanguines de 25-hydroxy vitamine D et de 1,25-dihydroxy vitamine D chez un patient en administrant, selon les besoins, des thérapies de réplétion à la fois de Vitamine D et de remplacement hormonal de vitamine D. Les concentrations sanguines de la 25-hydroxy vitamine D sont augmentées et maintenues à 30 ng/ml ou moins, et les concentrations sanguines de la 1,25-dihydroxy vitamine D sont augmentées ou maintenues dans une plage physiologique historique normale pour le patient de la 1,25-dihydroxy vitamine D sans risquer une augmentation sensible de l'hypercalcémie, de l'hyperphosphatémie ni de suppression excessive de l'iPTH plasmique du patient. Les taux sanguins de la 25-hydroxy vitamine D sont maintenus à 30 ng/ml ou moins entre des doses de thérapie de réplétion de vitamine D, et les taux sanguins de la 1,25-dihydroxy vitamine D sont maintenus dans la plage physiologique historique normale pour le patient entre les doses de thérapies de remplacement hormonal de la vitamine D. Sous un aspect, l'invention concerne des procédés dans lesquels, pendant le traitement, la concentration sanguine de la 25-hydroxy vitamine D comprend de façon prédominante la 25-hydroxy vitamine D3 et/ou dans lesquels le procédé comprend l'administration de façon prédominante ou unique de la 25-hydroxy vitamine D3 pour la réplétion et/ou l'entretien de la 25-hydroxy vitamine D.

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