Mini-review: new therapeutic options in hypoparathyroidism

Hypoparathyroidism is a disorder characterized by hypocalcemia and low or absent parathyroid hormone (PTH). While standard treatment of hypoparathyroidism consists of oral calcium and vitamin D supplementation, maintaining serum calcium levels can be a challenge, and concerns exist regarding hyperca...

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Bibliographic Details
Published in:Endocrine 2012-06, Vol.41 (3), p.410-414
Main Authors: Cusano, Natalie E., Rubin, Mishaela R., Sliney, James, Bilezikian, John P.
Format: Article
Language:English
Subjects:
Bone Density
Bone Density Conservation Agents - therapeutic use
Bone Remodeling
Diabetes
Endocrinology
Hormone Replacement Therapy
Humanities and Social Sciences
Humans
Hypoparathyroidism - diagnosis
Hypoparathyroidism - diet therapy
Hypoparathyroidism - drug therapy
Hypoparathyroidism - physiopathology
Internal Medicine
Medicine
Medicine & Public Health
Mini Review
multidisciplinary
Parathyroid Hormone - therapeutic use
Peptide Fragments - therapeutic use
Recombinant Proteins - therapeutic use
Science
Teriparatide - therapeutic use
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Summary:Hypoparathyroidism is a disorder characterized by hypocalcemia and low or absent parathyroid hormone (PTH). While standard treatment of hypoparathyroidism consists of oral calcium and vitamin D supplementation, maintaining serum calcium levels can be a challenge, and concerns exist regarding hypercalciuria and ectopic calcifications that can be associated with such treatment. Hypoparathyroidism is the only classic endocrine deficiency disease for which the missing hormone, PTH, is not yet an approved treatment. This mini-review focuses on the use of PTH in the treatment of hypoparathyroidism. There are two available formulations of PTH: teriparatide [human PTH(1-34)] and the full-length molecule, PTH(1-84). Both PTH(1-34) and PTH(1-84) lower supplemental vitamin D requirements and increase markers of bone turnover. Densitometric and histomorphometric studies in some subjects treated with PTH(1-84) demonstrate improvement in abnormal bone-remodeling dynamics and return of bone metabolism toward normal euparathyroid levels. Further detailed examination of skeletal features following therapy with the different treatment regimens and data regarding the effect of PTH on quality of life measures are under active investigation.
ISSN:1355-008X
1559-0100
DOI:10.1007/s12020-012-9618-y