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PTH therapy improved long-term health of hypoparathyroid patients
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Patients with hypoparathyroidism could achieve mental and physical health improvements with recombinant human parathyroid hormone I-84 therapy, according to research published in The Journal of Clinical Endocrinology & Metabolism.
The findings from a study conducted by Natalie E. Cusano, MD, of the department of medicine at Columbia University, add to biochemical and skeletal improvements already documented with the treatment.
The researchers evaluated 69 patients with hypoparathyroidism who received open-label parathyroid hormone (PTH) 1-84 for 5 years to determine the effects of treatment on quality of life.
Patients completed the 36-item short-form health survey (SF-36), covering eight areas of physical and mental health, at baseline and during therapy. Those who enrolled early received 100 mg every other day, but regimens of 25 mg, 50 mg and 75 mg daily were made available; PTH 1-84 dose and calcium and vitamin D supplements were titrated based on biochemical parameters.
Before the study, patient scores were significantly lower than normative reference range for all eight areas (T-scores: –1.4 to –0.9; P<.001 for all). Significant improvements in overall scores were seen with PTH therapy at 2 months and persisted through 5 years, based on intention-to-treat analysis (386 ± 19 to 482 ± 25; P<.0001).
Mental component summary scores also showed improvement at 2 months that remained at the end of study (199 ± 11 to 246 ± 14; P=.001). All four individual mental health domains — vitality, social functioning, emotional role and mental health — and T-scores also improved.
Similar improvements in physical component summary scores were seen at those time points (187 ± 10 to 237 ± 13; P<.0001). Three physical health domains — physical functioning, physical role and general health — and T-scores also improved.
“Further study in a randomized, placebo-controlled manner using PTH doses titrated by biochemical parameters would help to confirm these observations,” the researchers wrote.
Disclosure: The research was supported by a grant from the NIH and NPS Pharmaceuticals. One researcher reports being a consultant for Amgen, Eli Lilly, GlaxoSmithKline, Merck, NPS and Radius.
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