Endocrine Abstracts

JOINT1390

Introduction: The year 2024 was marked by a significant shortage of Alfacalcidol in our country, leading to notable challenges in daily medical practice. Alfacalcidol, a crucial vitamin D analog, plays a vital role in managing calcium homeostasis particularly in patients with hypoparathyroidism. The unavailability of this essential medication has had direct consequences on patient care, particularly an observed increase in hospital admissions for hypocalcemia.

Objectives: To evaluate the impact of the Alfacalcidol shortage on our routine clinical practice by analyzing hospitalization rates, patient outcomes, and alternative treatment strategies.

Patients and Methods: This is a retrospective study including 34 patients hospitalized in the Endocrinology and Diabetology Department of Ibn Rochd University Hospital in Casablanca for acute hypocalcemia in 2024. Data were analyzed using IBM SPSS Statistics 27.0.

Results: In 2024, hospitalizations for acute hypocalcemia saw a significant rise, reaching a peak of 34 cases. The mean age was 50.88 years with a female predominance of 85.9%. The average duration of symptoms was 13 days. Patients experienced tetany episodes, with 23% showing QT interval prolongation on ECG. The mean corrected calcium level at admission was 61 mg/l. Etiologies included 88.2% post-surgical hypoparathyroidism, 11.8% autoimmune hypoparathyroidism. Before hospitalization, all patients were on replacement therapy (calcium and alfacalcidol was replaced with cholecalciferol). Patients received intravenous calcium infusion with a good clinical and biological response.

Conclusions: The 2024 Alfacalcidol shortage had a significant impact on clinical practice, leading to a sharp increase in hospitalizations for acute hypocalcemia. This highlights the crucial role of Alfacalcidol in preventing severe complications and underscores the need for better strategies to mitigate the effects of future drug shortages.