Endocrine Abstracts

Phosphate is an essential ion for mineralization of bone. Hypophosphatemia leads to rickets and osteomalacia whereas hyperphosphatemia promotes ectopic calcification in soft tissues. FGF23 is a polypeptide hormone secreted by bone that regulates serum phosphate concentration. It acts on kidney to decrease phosphate reabsorption, and 1,25-dihydroxy vitamin D secretion which in turn reduces phosphorus absorption by the gut. Its action on the renal tubule appears to require PTH a...

The cell surface calcium receptor (CaR) in the parathyroid gland plays a central role in the regulation of serum calcium homeostasis. Activation and inactivation mutations in the CaR lead to chronic hypocalcemia and hypercalcemia states (Brown, EM. Mutations in the calcium-sensing receptor and their clinical implications. Horm Res 1997 48 199–208). Type 11 calcimimetics are a novel class of compounds that directly reduce PTH secretion from the parathyroid ce...

Introduction: MRONJ is defined as exposed bone in the maxillofacial region that persists after eight weeks in patients treated with antiresorptive or anti-angiogenic drugs, without previous radiotherapy. The estimated United Kingdom incidence of MRONJ in osteoporosis patients is 0.01-0.1% (1). MRONJ can cause severe disfigurement, speech and feeding difficulties. We aim to investigate MRONJ incidence and utility of dental screening in patients receiving Zoledronate ...

Background: Despite the widespread use of the 250-μg Cosyntropin test (ACTH test) for the diagnosis of adrenal insufficiency (AI), the effect of timing of the test on 30- vs. 60-min serum cortisol values remains unclear. Also, there is limited evidence comparing the value of performing both 30- and 60-min cortisol levels.Methods: We conducted a retrospective cohort study of all ACTH tests conducted at the Halifax Neuropituitary Program, Nova Scotia,...

Patients with persistent PHPT after parathyroidectomy (PTX) or contraindications for PTX often require chronic treatment for hypercalcemia, representing an unmet medical need. In an open-label, single-arm study in the US and EU, 17 patients underwent a variable length titration phase (maximum 16 weeks) with a maintenance phase (MP) of up to 3 years. Patients were eligible if they had (1) persistent PHPT following PTX or were considered contraindicated for PTX, and (2) serum ca...

Introduction: Primary aldosteronism (PA) is both the most common form of secondary hypertension and a high-risk subset associated with increased cardiovascular, cerebrovascular and renal morbidity compared to essential hypertension. Unilateral PA is amenable to surgery, biochemical cure and reversal of this excess risk; whilst bilateral disease is best treated through mechanism-directed medical therapy. Currently, PA subtype classification relies on adrenal venous sampling (AV...

Background: RACE is an open-label study that assessed the long-term safety and efficacy of recombinant human parathyroid hormone 1–84 (rhPTH[1–84]) for the treatment of hypoparathyroidism in adults (ClinicalTrials.gov identifier NCT01297309). Here, we present 6-year safety and efficacy data.Methods: Patients initially received 25 or 50 μg of rhPTH(1–84) subcutaneously, once daily, with stepwise dose adjustments of 25 μg (up or do...

Hypoparathyroidism (HPT) is characterised by hypocalcaemia and impaired renal phosphate excretion and calcium conservation. Oral calcium supplements and calcitriol can improve serum calcium levels but lack the physiologic effects of PTH on renal reabsorption of calcium. RACE is an ongoing open-label study evaluating the long-term safety of recombinant human parathyroid hormone 1-84 (rhPTH[1-84], parathyroid hormone rDNA) in adults with HPT (NCT01297309). In this interim analys...

Hypoparathyroidism is a disorder of mineral homoeostasis due to parathyroid hormone (PTH) deficiency. Conventional treatment with oral Ca and calcitriol may maintain serum Ca levels but does not replace other physiologic PTH effects. RACE is an ongoing open-label study of recombinant human PTH1-84 (rhPTH1-84) for hypoparathyroidism treatment in adults (ClinicalTrials.gov NCT01297309). Patients initially received rhPTH1-84 25 or 50 μg/day subcutaneously, with 25-μg in...