Published in:
01-11-2010 | Original Article
Therapy of hypoparathyroidism with intact parathyroid hormone
Published in: Osteoporosis International | Issue 11/2010
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Summary
Hypoparathyroidism, a disorder characterized by low parathyroid hormone (PTH), is generally treated with oral calcium and vitamin D supplementation. We investigated the effects of PTH(1–84) treatment in 30 hypoparathyroid subjects for 24 months. PTH(1–84) treatment in hypoparathyroidism significantly reduced supplemental calcium and 1,25-dihydroxyvitamin D requirements without generally altering serum and urinary calcium levels.
Introduction
Hypoparathyroidism, a disorder characterized by low PTH, is associated with hypocalcemia, hypercalciuria, and increased bone mineral density (BMD). Conventional therapy with calcium and 1,25-dihydroxyvitamin D can maintain the serum calcium concentration, but doses are high, and control is variable. We investigated the effects of human PTH(1–84) treatment in hypoparathyroidism.
Methods
Thirty subjects with hypoparathyroidism were treated in an open-label study of PTH(1–84) 100 µg every other day by subcutaneous injection for 24 months, with monitoring of calcium and vitamin D supplementation requirements, serum and 24 h urinary calcium excretion, and BMD by dual energy X-ray absorptiometry.
Results
Requirements for supplemental calcium decreased significantly (3,030 ± 2,325 to 1,661 ± 1,267 mg/day (mean ± SD); p < 0.05), as did requirements for supplemental 1,25-dihydroxyvitamin D (0.68 ± 0.5 to 0.40 ± 0.5 µg/day; p < 0.05). Serum calcium levels and 24 h urinary calcium excretion were mostly unchanged at 24 months. BMD increased at the lumbar spine by 2.9 ± 4% from baseline (p < 0.05), while femoral neck BMD remained unchanged and distal one third radial BMD decreased by 2.4 ± 4% (p < 0.05).
Conclusion
PTH(1–84) treatment in hypoparathyroidism significantly reduces supplemental calcium and 1,25-dihydroxyvitamin D requirements without generally altering serum and urinary calcium levels.