Endocrine Abstracts

Hypoparathyroidism is characterised by parathyroid hormone (PTH) levels inadequate to maintain plasma calcium concentration within the normal range. Even if the conventional treatment with calcium supplements and active vitamin D analogues is usually able to maintain normocalcemia, episodic low plasma calcium, neuromuscular complaints, renal disease and gastric discomfort are not infrequent. 29 patients with post-surgical hypoparathyroidism were started on PTH 1–34 therapy, because of persistent low plasma calcium, related to low calcium intake due to calcium intolerance and decreased quality of life (QoL). The still ongoing protocol includes periodic visits with biochemical exams, quantitative ultrasound of calcaneus (QUS) and a questionnaire to assess QoL. We present the preliminary data on the 14 patients (12 females, mean age: 60.7±9.29 years old), who have completed the 6-month follow up, reaching the 1-year visit in six cases. At the baseline, the mean plasma calcium was 7.68±0.68 mg/dl (normal range: 8.6–10.2) and the mean 24-h urinary calcium was 218.71±161.4 mg/dl (normal range: 100–300). PTH 1–34 was added at an initial dose of 0.5–0.7 μg/kg (~20–80 μg/die), twice a day. The PTH 1–34 and vitamin D analogues were titrated based on clinical and biochemical results, while the calcium supplements were progressively stopped in all patients. At the 6-month follow up, the mean plasma calcium was 8.84±0.93 mg/dl (+15%) and the mean 24-h urinary calcium was 267.36±98.3 mg/dl (+22%). The QoL had improved in all patients. The muscular pain, referred in three patients, was the most common complaint, causing a temporary discontinuation of PTH 1–34 only in one case. No serious adverse events were reported. These preliminary results have confirmed the efficacy and safety of PTH 1–34 in post-surgical hypoparathyroidism. The ongoing follow up will define the long-term effects of PTH 1–34-RT.