Shoji T, Nakatani S, Kabata D, et al. - In Japanese patients with secondary hyperparathyroidism undergoing hemodialysis, experts aspired to explore whether calcimimetic agent etelcalcetide is more effective in increasing T ₅₀ value than a vitamin D receptor activator maxacalcitol. Study participants were randomly assigned to obtain intravenous etelcalcetide 5 mg thrice weekly (etelcalcetide group) or intravenous maxacalcitol 5 or 10 µg thrice weekly (maxacalcitol group). A total of 425 patients from 23 dialysis centers were screened for eligibility, 326 patients were randomized (etelcalcetide, n = 167; control, n = 159), and 321 were involved in the intention-to-treat analysis (median age, 66 years; 113 women [35%]). According to this randomized, multicenter, open-label, blinded endpoint trial with active control, in patients on hemodialysis with secondary hyperparathyroidism, etelcalcetide was more effective in increasing T ₅₀ value than maxacalcitol. No difference was found in handgrip strength or cognition between the two drugs.