Literature DB >> 20094706

Therapy of hypoparathyroidism with intact parathyroid hormone.

M R Rubin1, J Sliney, D J McMahon, S J Silverberg, J P Bilezikian.   

Abstract

UNLABELLED: 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.

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Year:  2010        PMID: 20094706      PMCID: PMC2947814          DOI: 10.1007/s00198-009-1149-x

Source DB:  PubMed          Journal:  Osteoporos Int        ISSN: 0937-941X            Impact factor:   4.507


  12 in total

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Review 3.  Genetics of endocrine and metabolic disorders: parathyroid.

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Authors:  V P Michelangeli; P Heyma; P G Colman; P R Ebeling
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5.  Calcium-regulating hormones and the kidney.

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6.  Synthetic human parathyroid hormone 1-34 vs calcitriol and calcium in the treatment of hypoparathyroidism.

Authors:  K K Winer; J A Yanovski; G B Cutler
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7.  Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone-(1-34) versus calcitriol and calcium.

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Authors:  C Christiansen; P Rødbro; M S Christensen; B Hartnack; I Transbøl
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10.  A randomized, cross-over trial of once-daily versus twice-daily parathyroid hormone 1-34 in treatment of hypoparathyroidism.

Authors:  K K Winer; J A Yanovski; B Sarani; G B Cutler
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Review 1.  Mini-review: new therapeutic options in hypoparathyroidism.

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2.  The lady with a calcified brain.

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Review 7.  Recombinant Human Parathyroid Hormone (1-84): A Review in Hypoparathyroidism.

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Review 10.  Bone imaging in hypoparathyroidism.

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