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Vitamin D2 lowers severe hypocalcemia rates in hypoparathyroidism
Hypocalcemia in adults with hypoparathyroidism can be effectively treated with vitamin D2, and rates of severe hypocalcemia are lower with vitamin D2 compared with calcitriol treatment, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Elizabeth A. Streeten, MD, clinical professor at the University of Maryland School of Medicine in Baltimore, and colleagues evaluated 30 adults with hypoparathyroidism (duration 4 years) treated chronically with vitamin D2 (n = 16; mean age; 58.9 years) or calcitriol (n = 14; mean age, 50.9 years) to compare renal function and rates of hypercalcemia and hypocalcemia among them.
Mean serum creatinine, mean corrected serum calcium and urine calcium levels and renal imaging results were not significantly different between the two groups.
Emergency treatment for hypocalcemia was required by four participants in the calcitriol group compared with none in the vitamin D2 group (P = .03); three participants in the calcitriol group who received emergency treatment required multiple visits.
No significant difference was found between the groups for number of hospitalizations or ED visits for hypercalcemia.
“The clinical implications are that high-dose vitamin D2, although an ‘old-fashioned’ treatment, is effective and safe to treat hypoparathyroidism,” Streeten told Endocrine Today. “Specifically, compared to calcitriol, we found no difference in episodes of hypercalcemia or serum creatinine after long-term follow-up with D2 treatment. In addition, we found fewer episodes of severe hypocalcemia with vitamin D2 treatment compared to calcitriol. Vitamin D2 treatment should be considered in the chronic treatment of hypoparathyroidism, particularly in patients who experience severe hypocalcemia while on treatment with calcitriol. Our results should be confirmed by a long-term, prospective, controlled trial of vitamin D2 vs. calcitriol.” – by Amber Cox
For more information:
Elizabeth A. Streeten, MD, can be reached at estreete@medicine.umaryland.edu.
Disclosure: The researchers report no relevant financial disclosures.