Terapia usando agente de repleción de la vitamina D y agente de reemplazo de la hormona de la vitamina D

Un medicamento que es una combinación de (i) una terapia de repleción de vitamina D, que es uno o más compuestos seleccionados de prohormonas de vitamina D y (ii) una terapia de reemplazo de la hormona de vitamina D, que es uno o más compuestos seleccionados de hormonas de vitamina D activas y análogos de la hormona de vitamina D activa que son compuestos de vitamina D 1α-hidroxilados, para el uso en el tratamiento de (a) un paciente que tiene hiperparatiroidismo; y/o (b) un paciente que tiene enfermedad renal crónica etapa 5. A method of treating elevated blood levels of iPTH by increasing or maintaining blood concentrations of both 25-hydroxyvitamin 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-hydroxyvitamin 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-hydroxyvitamin D3, and/or wherein the method includes administering predominantly or solely 25-hydroxyvitamin D3for 25-hydroxyvitamin D repletion and/or maintenance.