Facing cinacalcet-induced hypocalcemia: sit back and relax?

A post hoc analysis of data from the EVOLVE study demonstrates that cinacalcet-induced hypocalcemia is common, mostly asymptomatic, and resolves spontaneously. These findings are reassuring and may warrant therapeutic inertia. However, previous studies in parathyroidectomized patients suggest that calcium repletion may be beneficial and safe from bone and cardiovascular perspectives, respectively, and as such call into question the appropriateness of a "sit back and relax" attitude toward cinacalcet-induced hypocalcemia.