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c a u s e + m o r t a l i t y + o r + f i r s t + n o n - f a t a l + c a r d i o v a s c u l a r + e v e n t % 2 c + i n c l u d i n g + m y o c a r d i a l + i n f a r c t i o n % 2 c + h o s p i t a l i z a t i o n + f o r + u n s t a b l e + a n g i n a % 2 c + h e a r t + f a i l u r e + o r + p e r i p h e r a l + v a s c u l a r + e v e n t + a l t h o u g h + p a t i e n t s + i n + t h e + s e n s i p a r % 2 f m i m p a r a + a r m + e x p e r i e n c e d + n u m e r i c a l l y + f e w e r + c o m p o s i t e + p r i m a r y + e v e n t s % 2 c + t h e + r e s u l t s + w e r e + n o t + s t a t i s t i c a l l y + s i g n i f i c a n t % 2 c + a n d + t h e + t r i a l + d i d + n o t + m e e t + i t s + p r i m a r y + e n d p o i n t + i n + t h e + i n t e n t - t o - t r e a t + a n a l y s i s + % 0 a % 0 d % 0 a % 2 2 a m g e n + e m b a r k e d + o n + t h e + e v o l v e + t r i a l + t o + u n d e r s t a n d + w h e t h e r + t r e a t i n g + s e c o n d a r y + h p t + w i t h + s e n s i p a r % 2 f m i m p a r a + c o u l d + p o s i t i v e l y + i m p a c t + t h e + h i g h + r a t e s + o f + m o r t a l i t y + a n d + c a r d i o v a s c u l a r + e v e n t s + a m o n g + p a t i e n t s + w i t h + c k d + r e c e i v i n g + d i a l y s i s % 2 c % 2 2 + s a i d + s e a n + e + h a r p e r % 2 c + m d % 2 c + e x e c u t i v e + v i c e + p r e s i d e n t + o f + r e s e a r c h + a n d + d e v e l o p m e n t + a t + a m g e n + % 2 2 w e + t h a n k + t h e + p a t i e n t s % 2 c + c a r e g i v e r s + a n d + i n v e s t i g a t o r s + f o r + t h e i r + p a r t i c i p a t i o n + a n d + e n g a g e m e n t + i n + t h i s + l a n d m a r k + t r i a l + e v o l v e + w i l l + p r o v i d e + t h e + n e p h r o l o g y + c o m m u n i t y + w i t h + i m p o r t a n t + i n f o r m a t i o n % 2 2 + % 0 a % 0 d % 0 a t h e + m o s t + f r e q u e n t l y + r e p o r t e d + a d v e r s e + e v e n t s + i n + t h e + s e n s i p a r % 2 f m i m p a r a + a r m + o f + t h e + t r i a l + w e r e + c o n s i s t e n t + w i t h + t h e + k n o w n + s a f e t y + p r o f i l e + o f + t h i s + t h e r a p y + a n d + i n c l u d e d + n a u s e a % 2 c + v o m i t i n g + a n d + h y p o c a l c e m i a + % 0 a % 0 d % 0 a d e t a i l e d + e f f i c a c y + a n d + s a f e t y + a n a l y s e s + f r o m + t h i s + l a n d m a r k + s t u d y + a r e + o n g o i n g + a n d + w i l l + b e + s u b m i t t e d + f o r + p r e s e n t a t i o n + a t + a + m a j o r + m e d i c a l + m e e t i n g + l a t e r + t h i s + y e a r % 0 a % 0 d % 0 a s e n s i p a r % 2 f m i m p a r a + i s + a n + o r a l + c a l c i m i m e t i c + a g e n t + a p p r o v e d + f o r + t h e + t r e a t m e n t + o f + s e c o n d a r y + h p t + i n + p a t i e n t s + w i t h + c k d + r e c e i v i n g + d i a l y s i s % 0 a % 0 d % 0 a % 0 d % 0 a e v o l v e + t r i a l + d e s i g n % 0 a % 0 d % 0 a e v o l v e + w a s + a n + i n t e r n a t i o n a l % 2 c + r a n d o m i z e d % 2 c + d o u b l e - b l i n d % 2 c + p l a c e b o - c o n t r o l l e d + p h a s e + 3 + s t u d y + o f + 3 % 2 c 8 8 3 + p a t i e n t s + w i t h + s e c o n d a r y + h p t + a n d + c k d + r e c e i v i n g + d i a l y s i s + t h e + t r i a l % 2 c + t h e + l a r g e s t + o f + i t s + k i n d + i n + p a t i e n t s + w i t h + c k d + r e c e i v i n g + d i a l y s i s % 2 c + w a s + d e s i g n e d + t o + d e t e r m i n e + i f + t r e a t m e n t + w i t h + s e n s i p a r % 2 f m i m p a r a % 2 c + c o m p a r e d + t o + p l a c e b o % 2 c + d e c r e a s e s + t h e + r i s k + o f + a l l - c a u s e + m o r t a l i t y + a n d + c v + m o r b i d i t y + t h e + t r i a l + c o n s i s t e d + o f + a + 3 0 - d a y + s c r e e n i n g + p h a s e % 2 c + a + t i t r a t i o n + p h a s e + w i t h + v i s i t s + e v e r y + 2 + w e e k s % 2 c + a n d + a + f o l l o w - u p + p h a s e + w i t h + v i s i t s + e v e r y + 8 + w e e k s + f o l l o w i n g + t h e + s c r e e n i n g + p h a s e % 2 c + p a t i e n t s + w e r e + r a n d o m i z e d + t o + t h e + s e n s i p a r % 2 f m i m p a r a + o r + p l a c e b o + g r o u p s + p o s s i b l e + s e q u e n t i a l + d o s e s + o f + s e n s i p a r % 2 f m i m p a r a + o r + p l a c e b o + i n c l u d e d + 3 0 % 2 c + 6 0 % 2 c + 9 0 % 2 c + 1 2 0 % 2 c + a n d + 1 8 0 + m g + f l e x i b l e + u s e + o f + t r a d i t i o n a l + t h e r a p i e s % 2 c + s u c h + a s + v i t a m i n + d + d e r i v a t i v e s + a n d + p h o s p h a t e + b i n d e r s % 2 c + w e r e + p e r m i t t e d + i n + b o t h + g r o u p s % c 3 % 8 2 % c 2 % a 0 + % 0 a % 0 d % 0 a % 0 d % 0 a a b o u t + s e c o n d a r y + h y p e r p a r a t h y r o i d i s m % 0 a % 0 d % 0 a s e c o n d a r y + h y p e r p a r a t h y r o i d i s m + % 2 8 h p t % 2 9 + i s + a + c o m m o n + a n d + s e r i o u s + c o n d i t i o n + t h a t + i s + o f t e n + p r o g r e s s i v e + a m o n g + p a t i e n t s + w i t h + c k d + a n d + i t + a f f e c t s + m a n y + o f + t h e + a p p r o x i m a t e l y + t w o + m i l l i o n + p e o p l e + t h r o u g h o u t + t h e + w o r l d + w h o + a r e + r e c e i v i n g + d i a l y s i s + t h e + d i s o r d e r + d e v e l o p s + e a r l y + a s + a n + a d a p t i v e + r e s p o n s e + t o + d e c l i n i n g + k i d n e y + f u n c t i o n + w h e n + t h e + p a r a t h y r o i d + g l a n d s + % 2 8 f o u r + s m a l l + g l a n d s + i n + t h e + n e c k % 2 9 + i n c r e a s e + t h e + p r o d u c t i o n + o f + p a r a t h y r o i d + h o r m o n e + % 2 8 p t h % 2 9 + i n + a n + e f f o r t + t o + m a i n t a i n + n o r m a l + l e v e l s + o f + c a l c i u m + a n d + p h o s p h o r u s + u l t i m a t e l y % 2 c + e x c e s s + p t h + p r o d u c t i o n + p r o v e s + i n a d e q u a t e + f o r + m a i n t a i n i n g + n o r m a l + s e r u m + c a l c i u m + a n d + p h o s p h o r o u s + l e v e l s + w h e n + k i d n e y + d i s e a s e + p r o g r e s s e s + t o + t h e + p o i n t + w h e r e + d i a l y s i s + i s + n e e d e d + t o + s u s t a i n + l i f e % 2 c + s e c o n d a r y + h p t + m a n i f e s t s + a s + e l e v a t e d + p t h % 2 c + c a l c i u m + a n d + p h o s p h o r u s + l e v e l s + t h a t % 2 c + i n + t u r n % 2 c + c a n + l e a d + t o + s i g n i f i c a n t + c l i n i c a l + c o n s e q u e n c e s % 2 c + i n c l u d i n g + b o n e + l o s s % 2 c + s k e l e t a l + f r a c t u r e % 2 c + a n d + s o f t - t i s s u e + c a l c i f i c a t i o n + a l t h o u g h + m a n y + p a t i e n t s + w i t h + s e c o n d a r y + h p t + a r e + n o t + o v e r t l y + s y m p t o m a t i c % 2 c + b o n e + p a i n % 2 c + p a r t i c u l a r l y + w h e n + s t a n d i n g + o r + w h e n + w a l k i n g % 2 c + a c h y + a n d + s t i f f + j o i n t s % 2 c + m u s c l e + w e a k n e s s % 2 c + a n d + c o m p l a i n t s + o f + d r y % 2 c + i t c h y + s k i n + a r e + c o m m o n + a d v a n c e d + d i s e a s e + i s + m a r k e d + b y + v e r y + l a r g e + p a r a t h y r o i d + g l a n d s + t h a t + m a y + n e e d + t o + b e + r e m o v e d + b y + s u r g e r y % 0 a % 0 d % 0 a % 0 d % 0 a a b o u t + s e n s i p a r % 2 f m i m p a r a + % 2 8 c i n a c a l c e t % 2 9 % 0 a % 0 d % 0 a c i n a c a l c e t + i s + a p p r o v e d + i n + m o r e + t h a n + 5 0 + c o u n t r i e s + a n d + m a r k e t e d + a s + s e n s i p a r + i n + t h e + u n i t e d + s t a t e s + % 2 8 u s % 2 9 % 2 c + c a n a d a % 2 c + a u s t r a l i a + a n d + n e w + z e a l a n d + a n d + a s + m i m p a r a + i n + t h e + e u r o p e a n + u n i o n + a n d + o t h e r + c o u n t r i e s + s e n s i p a r % 2 f m i m p a r a + i s + t h e + f i r s t + o r a l + c a l c i m i m e t i c + a g e n t + a p p r o v e d + f o r + t h e + t r e a t m e n t + o f + s e c o n d a r y + h p t + i n + c k d + p a t i e n t s + r e c e i v i n g + d i a l y s i s + t h e + t h e r a p y + i s + a l s o + a p p r o v e d + b y + t h e + u s + f o o d + a n d + d r u g + a d m i n i s t r a t i o n % 2 c + e u r o p e a n + m e d i c i n e s + a g e n c y + a n d + h e a l t h + c a n a d a + f o r + h y p e r c a l c e m i a + i n + p a t i e n t s + w i t h + p a r a t h y r o i d + c a r c i n o m a + a n d + s e v e r e + h y p e r c a l c e m i a + i n + p a t i e n t s + w i t h + p r i m a r y + h p t + w h o + a r e + u n a b l e + t o + u n d e r g o + p a r a t h y r o i d e c t o m y + s e n s i p a r % 2 f m i m p a r a + b i n d s + t o + t h e + c a l c i u m - s e n s i n g + r e c e p t o r % 2 c + w h i c h + c a u s e s + t h e + r e c e p t o r + t o + b e c o m e + m o r e + s e n s i t i v e + t o + e x t r a c e l l u l a r + c a l c i u m + i o n s + t h i s + r e s u l t s + i n + a + d r o p + i n + p t h + l e v e l s + b y + i n h i b i t i n g + p t h + s y n t h e s i s + a n d + s e c r e t i o n + i n + a d d i t i o n % 2 c + t h e + r e d u c t i o n s + i n + p t h + l o w e r + s e r u m + c a l c i u m + a n d + p h o s p h o r u s + l e v e l s % 0 a % 0 d % 0 a % 0 d % 0 a s e c o n d a r y + h p t + i n d i c a t i o n s e n s i p a r + i s + i n d i c a t e d + f o r + t h e + t r e a t m e n t + o f + s e c o n d a r y + h p t + i n + p a t i e n t s + w i t h + c k d + o n + d i a l y s i s % 0 a % 0 d % 0 a p r i m a r y + h p t + i n d i c a t i o n s e n s i p a r + i s + i n d i c a t e d + f o r + t h e + t r e a t m e n t + o f + s e v e r e + h y p e r c a l c e m i a + i n + p a t i e n t s + w i t h + p r i m a r y + h p t + w h o + a r e + u n a b l e + t o + u n d e r g o + p a r a t h y r o i d e c t o m y % 0 a % 0 d % 0 a % 0 d % 0 a i m p o r t a n t + s a f e t y + i n f o r m a t i o n % 0 a % 0 d % 0 a s e n s i p a r + l o w e r s + s e r u m + c a l c i u m % 3 b + t h e r e f o r e % 2 c + i t + i s + i m p o r t a n t + t h a t + p a t i e n t s + a r e + c a r e f u l l y + m o n i t o r e d + f o r + t h e + o c c u r r e n c e + o f + h y p o c a l c e m i a + s e n s i p a r + s h o u l d + n o t + b e + i n i t i a t e d + i f + s e r u m + c a l c i u m + i s + l e s s + t h a n + t h e + l o w e r + l i m i t + o f + t h e + n o r m a l + r a n g e + s i g n i f i c a n t + r e d u c t i o n s + i n + c a l c i u m + m a y + l o w e r + t h e + t h r e s h o l d + f o r + s e i z u r e s + i n + t h e + t r e a t m e n t + o f + s e c o n d a r y + h y p e r p a r a t h y r o i d i s m + t h e + m o s t + c o m m o n l y + r e p o r t e d + s i d e + e f f e c t s + i n + c l i n i c a l + t r i a l s + w e r e + n a u s e a % 2 c + v o m i t i n g % 2 c + a n d + d i a r r h e a + i n + t h e + t r e a t m e n t + o f + p r i m a r y + h y p e r t h y r o i d i s m % 2 c + t h e + m o s t + c o m m o n l y + r e p o r t e d + s i d e + e f f e c t s + i n + c l i n i c a l + t r i a l s + w e r e + n a u s e a % 2 c + v o m i t i n g % 2 c + a n d + p a r e s t h e s i a % 0 a % 0 d % 0 a t o + s e e + t h e + f u l l + s e n s i p a r + s a f e t y + i n f o r m a t i o n % 2 c + v i s i t + h t t p % 3 a % 2 f % 2 f p i a m g e n c o m % 2 f u n i t e d _ s t a t e s % 2 f s e n s i p a r % 2 f s e n s i p a r _ p i _ h c p _ e n g l i s h p d f + % 0 a % 0 d % 0 a % 0 d % 0 a a b o u t + a m g e n % 0 a % 0 d % 0 a a m g e n + d i s c o v e r s % 2 c + d e v e l o p s % 2 c + m a n u f a c t u r e s + a n d + d e l i v e r s + i n n o v a t i v e + h u m a n + t h e r a p e u t i c s + a + b i o t e c h n o l o g y + p i o n e e r + s i n c e + 1 9 8 0 % 2 c + a m g e n + w a s + o n e + o f + t h e + f i r s t + c o m p a n i e s + t o + r e a l i z e + t h e + n e w + s c i e n c e % 2 7 s + p r o m i s e + b y + b r i n g i n g + s a f e % 2 c + e f f e c t i v e + m e d i c i n e s + f r o m + l a b + t o + m a n u f a c t u r i n g + p l a n t + t o + p a t i e n t + a m g e n + t h e r a p e u t i c s + h a v e + c h a n g e d + t h e + p r a c t i c e + o f + m e d i c i n e % 2 c + h e l p i n g + m i l l i o n s + o f + p e o p l e + a r o u n d + t h e + w o r l d + i n + t h e + f i g h t + a g a i n s t + c a n c e r % 2 c + k i d n e y + d i s e a s e % 2 c + r h e u m a t o i d + a r t h r i t i s % 2 c + b o n e + d i s e a s e + a n d + o t h e r + s e r i o u s + i l l n e s s e s + w i t h + a + d e e p + a n d + b r o a d + p i p e l i n e + o f + p o t e n t i a l + n e w + m e d i c i n e s % 2 c + a m g e n + r e m a i n s + c o m m i t t e d + t o + a d v a n c i n g + s c i e n c e + t o + d r a m a t i c a l l y + i m p r o v e + p e o p l e % 2 7 s + l i v e s + t o + l e a r n + m o r e + a b o u t + o u r + p i o n e e r i n g + s c i e n c e + a n d + v i t a l + m e d i c i n e s % 2 c + v i s i t + h t t p % 3 a % 2 f % 2 f w w w a m g e n c o m % 2 f + f o l l o w + u s + o n + h t t p % 3 a % 2 f % 2 f t w i t t e r c o m % 2 f a m g e n % 0 a % 0 d % 0 a f o r w a r d - l o o k i n g + s t a t e m e n t s % 0 a % 0 d % 0 a t h i s + n e w s + r e l e a s e + c o n t a i n s + f o r w a r d - l o o k i n g + s t a t e m e n t s + t h a t + a r e + b a s e d + o n + m a n a g e m e n t % 2 7 s + c u r r e n t + e x p e c t a t i o n s + a n d + b e l i e f s + a n d + a r e + s u b j e c t + t o + a + n u m b e r + o f + r i s k s % 2 c + u n c e r t a i n t i e s + a n d + a s s u m p t i o n s + t h a t + c o u l d + c a u s e + a c t u a l + r e s u l t s + t o + d i f f e r + m a t e r i a l l y + f r o m + t h o s e + d e s c r i b e d + a l l + s t a t e m e n t s % 2 c + o t h e r + t h a n + s t a t e m e n t s + o f + h i s t o r i c a l + f a c t % 2 c + a r e + s t a t e m e n t s + t h a t + c o u l d + b e + d e e m e d + f o r w a r d - l o o k i n g + s t a t e m e n t s % 2 c + i n c l u d i n g + e s t i m a t e s + o f + r e v e n u e s % 2 c + o p e r a t i n g + m a r g i n s % 2 c + c a p i t a l + e x p e n d i t u r e s % 2 c + c a s h % 2 c + o t h e r + f i n a n c i a l + m e t r i c s % 2 c + e x p e c t e d + l e g a l % 2 c + a r b i t r a t i o n % 2 c + p o l i t i c a l % 2 c + r e g u l a t o r y + o r + c l i n i c a l + r e s u l t s + o r + p r a c t i c e s % 2 c + c u s t o m e r + a n d + p r e s c r i b e r + p a t t e r n s + o r + p r a c t i c e s % 2 c + r e i m b u r s e m e n t + a c t i v i t i e s + a n d + o u t c o m e s + a n d + o t h e r + s u c h + e s t i m a t e s + a n d + r e s u l t s + f o r w a r d - l o o k i n g + s t a t e m e n t s + i n v o l v e + s i g n i f i c a n t + r i s k s + a n d + u n c e r t a i n t i e s % 2 c + i n c l u d i n g + t h o s e + d i s c u s s e d + b e l o w + a n d + m o r e + f u l l y + d e s c r i b e d + i n + t h e + s e c u r i t i e s + a n d + e x c h a n g e + c o m m i s s i o n + % 2 8 s e c % 2 9 + r e p o r t s + f i l e d + b y + a m g e n % 2 c + i n c l u d i n g + a m g e n % 2 7 s + m o s t + r e c e n t + a n n u a l + r e p o r t + o n + f o r m + 1 0 - k + a n d + m o s t + r e c e n t + p e r i o d i c + r e p o r t s + o n + f o r m + 1 0 - q + a n d + f o r m + 8 - k + p l e a s e + r e f e r + t o + a m g e n % 2 7 s + m o s t + r e c e n t + f o r m s + 1 0 - k % 2 c + 1 0 - q + a n d + 8 - k + f o r + a d d i t i o n a l + i n f o r m a t i o n + o n + t h e + u n c e r t a i n t i e s + a n d + r i s k + f a c t o r s + r e l a t e d + t o + o u r + b u s i n e s s + u n l e s s + o t h e r w i s e + n o t e d % 2 c + a m g e n + i s + p r o v i d i n g + t h i s + i n f o r m a t i o n + a s + o f + j u n e + 8 % 2 c + 2 0 1 2 + a n d + e x p r e s s l y + d i s c l a i m s + a n y + d u t y + t o + u p d a t e + i n f o r m a t i o n + c o n t a i n e d + i n + t h i s + n e w s + r e l e a s e % 0 a % 0 d % 0 a n o + f o r w a r d - 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