Endocrine Abstracts

Osteoporosis in primary hyperparathyroidism is an indication for surgical referral. Anti-resorptive treatment may be used as a medical treatment in patients not suitable for or who decline surgery. However, given system restraints there are often long wait times from referral to surgery. We examined the time from referral to parathyroidectomy, the use of antiresorptive agents and follow-up DXA rates. We identified patients referred from our centre with osteoporosis on DXA on an ENT database of parathyroidectomies from 2023-2024. We collected demographics, diagnostic work-up data, time from referral to surgery, anti-resorptive use, pre/post-op DXA and histology. 34/69 (49%) of patients were referred from our department. Indication for surgery was osteoporosis in 18/34 (53%). Mean age was 67.4 years. At referral for surgery, 4/18 were already on osteoporosis treatment, 7/18 were started on treatment, totalling 11/18 (61%). Median time from referral to parathyroidectomy was 15 months (range 2-60 months). There were no hospitalisations for hypercalcemia or fractures prior to surgery. For those started on bone treatment 5/7 (71%) had a follow-up DXA at 18 months. 3/7 (42%) of those not started on bone treatment had a follow-up DXA post parathyroidectomy. Almost half of patients referred for surgical intervention have a diagnosis of osteoporosis with the majority started on bone treatment. There was a variable wait time from referral to parathyroidectomy with often significant delays. Many patients did not have follow up DXAs, this is of concern particularly where decision on treatment was deferred until post op.