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**1alpha,24S-dihydroxyvitamin D2 (LR-103)** is a synthetic analog of vitamin D2 and a naturally occurring "D-hormone" produced by the kidneys from vitamin D. It is one of the active metabolites derived from Hectorol (doxercalciferol). LR-103 was developed for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease (CKD). Mechanistically, it acts as an agonist at the vitamin D receptor to regulate calcium and parathyroid hormone levels. Studies indicate that LR-103 has similar potency to calcitriol but with significantly lower toxicity. It normalizes serum calcium and parathyroid hormone (PTH) levels without causing hypercalcemia and can correct bone abnormalities associated with secondary hyperparathyroidism and active vitamin D deficiency[1][2][4].
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