Therapy with PTH 1–34 or calcitriol and calcium in diverse etiologies of hypoparathyroidism over 27 years at a single tertiary care center
| Autor: | Bo Zhang, Michail S. Lionakis, Gordon B. Cutler, Monica M. Schmitt, Elise M. N. Ferré, Shangyuan Ye, Karen K. Winer |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Histology Adolescent Calcitriol Hypoparathyroidism Physiology Endocrinology Diabetes and Metabolism chemistry.chemical_element 030209 endocrinology & metabolism Calcium Gastroenterology Tertiary Care Centers Young Adult 03 medical and health sciences Subcutaneous injection 0302 clinical medicine Internal medicine medicine Vitamin D and neurology Humans Child Aged business.industry Phosphorus Middle Aged medicine.disease 030104 developmental biology chemistry Parathyroid Hormone Child Preschool Cohort Etiology Nephrocalcinosis business medicine.drug |
| Zdroj: | Bone. 149:115977 |
| ISSN: | 8756-3282 |
| DOI: | 10.1016/j.bone.2021.115977 |
| Popis: | Objective Hypoparathyroidism has heterogeneous genetic and acquired etiologies with a broad spectrum of severity. Herein we describe the clinical outcomes of the largest cohort of hypoparathyroid patients reported to date, who were followed over 27-years. Design Pooled analysis of current and past studies describing the differential responses to PTH 1–34 injections vs conventional therapy among the varied hypoPT etiologies. Methods 192 participants (ages 2–74 years) with hypoparathyroidism who received either calcitriol and calcium or PTH 1–34 by subcutaneous injection. Results Among the 4 main etiologic categories of hypoparathyroidism (autoimmune polyglandular failure type 1, activating mutation of the calcium receptor, surgical, and idiopathic hypoparathyroidism), we reveal significant differences in PTH 1–34 dose requirements, prevalence of nephrocalcinosis, biomarkers of mineral homeostasis, and pharmacodynamic profiles. Serum 1,25-dihydroxyvitamin D3 increased significantly (P Conclusions We conclude that the effects and dose-response of PTH 1–34 treatment differ according to the etiology of hypoparathyroidism. Postsurgical hypoPT maintained mean serum calcium levels in the mid- to low-normal range while concurrently maintaining normal mean urine calcium during long-term twice-daily PTH 1–34 therapy. |
| Databáze: | OpenAIRE |
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