PTH Treatment in Hypoparathyroidism

Tanja      Sikjaer; Lars      Rejnmark; Leif      Mosekilde

Abstract

Hypoparathyroidism (HypoPT) is one of the few major hormone deficiency diseases that are not usually treated with the missing hormone. Bovine parathyroid hormone (PTH) has been purified and used as an experimental treatment, as long as in 1928 by Fuller Albright. Treatment, however, was abolished mainly because of antibody formation and costs. The recent approval of fully humanized truncated parathyroid hormone (Teriparatide, PTH (1-34)) and intact parathyroid hormone (Preotact, PTH(1-84)) for treatment of osteoporosis, has made the PTH drugs more accessible and thereby made clinical trials with PTH treatment of HypoPT feasible. Recent clinical trials have shown that treatment with PTH (1-34) and PTH (1-84) can stabilize plasma calcium, normalize plasma phosphate and reduce urine excretion of calcium. Furthermore, it seems that some patients with hypoPT experience an improved quality of life when treated with PTH compared with conventional treatment with 1α-hydroxylated vitamin D metabolites and calcium supplements.

Keywords: Calcitriol, Calcium, Hypoparathyroidism, Parathyroid hormone, PTH (1-34), PTH (1-84), hypercalcaemia, deoxypyridinoline, pyridinoline